Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 240427 | MA |
NPI | 1316171184 |
---|---|
Provider Name | Vardan Amirbekian |
First Address | Albany, NY 12212-4890 |
Second Address | Albany, NY 12208-1707 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2009 |
Last Update Date | 05/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03435283 | (05) | NY |