Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 25MA10318000 | NJ |
NPI | 1134416001 |
---|---|
Provider Name | Yuriy Dudiy |
First Address | Brooklyn, NY 11209-2064 |
Second Address | Hackensack, NJ 07601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2011 |
Last Update Date | 23/08/2018 |