Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 173105-1 | NY |
NPI | 1013906403 |
---|---|
Provider Name | Sunday Asaju |
First Address | New Hartford, NY 13413-1001 |
Second Address | New Hartford, NY 13413-1001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2005 |
Last Update Date | 28/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01190963 | (05) | NY |