Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 236976 | NY |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 236976 | NY |
NPI | 1013997980 |
---|---|
Provider Name | Tal Dagan |
First Address | New York, NY 10017-1107 |
Second Address | New York, NY 10017-1107 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2006 |
Last Update Date | 24/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02807023 | (05) | NY |
I47258 | (02) |