Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | 233728 | NY |
NPI | 1235329046 |
---|---|
Provider Name | Yan Trokel |
First Address | New York, NY 10065-6114 |
Second Address | New York, NY 10065-6114 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2007 |
Last Update Date | 15/06/2017 |