Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | N005585 | NY |
Y | 222Z00000X | Podiatrist | N005585 | NY |
NPI | 1043246085 |
---|---|
Provider Name | Scott C Gawlik |
First Address | Brooklyn, NY 11228-3401 |
Second Address | Brooklyn, NY 11228-3401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 08/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01977944 | (05) | NY |
U75777 | (02) |