Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 234923 | NY |
N | 207NP0225X | Pediatric Dermatologist | 234923 | NY |
N | 207NS0135X | Procedural Dermatology | 234923 | NY |
NPI | 1255316121 |
---|---|
Provider Name | Seth Wilentz |
First Address | Philadelphia, PA 19195-2233 |
Second Address | New York, NY 10003-3314 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2005 |
Last Update Date | 28/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I27453 | (02) | NY |