Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 308337 | NY |
Y | 208200000X | Surgeon | 308337 | NY |
Y | 208600000X | Surgeon | 308337 | NY |
NPI | 1124387907 |
---|---|
Provider Name | Ryosuke Misawa |
First Address | Hawthorne, NY 10532-2140 |
Second Address | Valhalla, NY 10595-1530 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2012 |
Last Update Date | 08/07/2021 |