Individual
DR. MAKOTO IWAHARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
120 E 79TH ST, SUITE 1C, NEW YORK, NY 10075-0319
(212) 879-2328
(212) 879-1933
Mailing address
120 E 79TH ST, SUITE 1C, NEW YORK, NY 10075-0319
(212) 879-2328
(212) 879-1933
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
147656
NY
207RG0100X
Gastroenterology Physician
Primary
147656
NY
Other
Enumeration date
12/30/2007
Last updated
04/18/2008
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