Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD454298 | PA |
Y | 2080P0203X | Pediatric Critical Care Doctor | MT201478 | PA |
N | 2080P0204X | Pediatric Emergency Doctor | MD454298 | PA |
NPI | 1245593565 |
---|---|
Provider Name | Adam Dziorny |
First Address | Rochester, NY 14642-0001 |
Second Address | Rochester, NY 14642-4319 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2012 |
Last Update Date | 29/12/2020 |