Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 055394 | NY |
N | 1223P0700X | Prosthodontist | DN21489 | MA |
NPI | 1184044661 |
---|---|
Provider Name | Seiichi Yamano |
First Address | New York, NY 10010 |
Second Address | New York, NY 10010-4020 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2014 |
Last Update Date | 23/04/2014 |