Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | F3337401 | NY |
NPI | 1023004702 |
---|---|
Provider Name | Andrew Paul Aiken |
First Address | Syracuse, NY 13210-2716 |
Second Address | Syracuse, NY 13210-2716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2005 |
Last Update Date | 10/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02299549 | (05) | NY |
MA0867032 | DEA (01) | NY |
Q74875 | (02) | NY |
RB1816 | (05) | NY |