Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 223414 | NY |
NPI | 1013983097 |
---|---|
Provider Name | Walter M Ralph JR. |
First Address | Bronx, NY 10457-7606 |
Second Address | Bronx, NY 10457-7606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2006 |
Last Update Date | 09/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02348552 | (05) | NY |
6M8142 | BCBS (01) | NY |
H68790 | (02) | NY |
P2686068 | OXFORD (01) | NY |