Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | CP003663 | DE |
NPI | 1467780882 |
---|---|
Provider Name | Sewpersaud R Madho |
First Address | Schenectady, NY 12308-2525 |
Second Address | Schenectady, NY 12308-2525 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2009 |
Last Update Date | 09/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
400202272001 | CDPHP (01) | NY |