Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N005508 | NY |
NPI | 1194776500 |
---|---|
Provider Name | Vladimir Gertsik |
First Address | Brooklyn, NY 11235-6828 |
Second Address | Brooklyn, NY 11235-6828 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 18/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01948049 | (05) | NY |
U74417 | (02) |