Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP1101X | Primary Podiatric Medicine | 005093 | NY |
N | 213EP1101X | Primary Podiatric Medicine | 02607 | NJ |
Y | 213ES0131X | Foot Surgery | 005093 | NY |
N | 213ES0131X | Foot Surgery | 02607 | NJ |
NPI | 1053402438 |
---|---|
Provider Name | Salvatore Gaudino |
First Address | Brooklyn, NY 11209-2602 |
Second Address | Brooklyn, NY 11209-2602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 16/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01803956 | (05) | NY |
U59824 | (02) | NY |