Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 148203 | NY |
NPI | 1407952310 |
---|---|
Provider Name | Verghese George |
First Address | Melville, NY 11747-2208 |
Second Address | Melville, NY 11747-2208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 21/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00841492 | (05) | NY |
E28825 | (02) | NY |