Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 211707 | NY |
NPI | 1093875114 |
---|---|
Provider Name | Samuel Soffer |
First Address | New Hyde Park, NY 11040 |
Second Address | New Hyde Park, NY 11040 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2006 |
Last Update Date | 08/07/2007 |