Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 136197 | NY |
N | 207KA0200X | Allergist | 136197 | NY |
N | 208000000X | Pediatrician | 136197 | NY |
N | 2080P0201X | Pediatric Allergist | 136197 | NY |
NPI | 1275644023 |
---|---|
Provider Name | Stewart Kaplan |
First Address | Massapequa, NY 11758-5819 |
Second Address | Massapequa, NY 11758-5819 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A62307 | (02) |