Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | MFC1398 | FL |
Y | 208200000X | Surgeon | 291017 | NY |
Y | 208600000X | Surgeon | 291017 | NY |
NPI | 1659337533 |
---|---|
Provider Name | Seigo Nishida |
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 | 21/04/2006 |
Last Update Date | 22/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04172547 | (05) | NY |
2606321-00 | (05) | FL |
H37353 | (02) | FL |