Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 003619-1 | NY |
NPI | 1215020912 |
---|---|
Provider Name | Russell George Volpe |
First Address | Glen Head, NY 11545 |
Second Address | Ny, NY 10035 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T51319 | (02) | NY |