Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 104132 | NY |
NPI | 1033118310 |
---|---|
Provider Name | Stephen J Danziger |
First Address | Brooklyn, NY 11238-4955 |
Second Address | Brooklyn, NY 11238-4955 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2005 |
Last Update Date | 07/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00180956 | (05) | NY |
B18839 | (02) | NY |