Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 189933 | NY |
N | 208200000X | Surgeon | 189933 | NY |
N | 208600000X | Surgeon | 189933 | NY |
N | 2086S0102X | Surgical Critical Care | 189933 | NY |
NPI | 1558358481 |
---|---|
Provider Name | Thomas Diflo |
First Address | Hawthorne, NY 10532-2140 |
Second Address | Valhalla, NY 10595-1530 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2005 |
Last Update Date | 30/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
81K741 | (05) | NY |
A58586 | (02) | NY |