Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 261178 | NY |
NPI | 1043417249 |
---|---|
Provider Name | Bernadette Dunn |
First Address | Syracuse, NY 13210-2342 |
Second Address | Syracuse, NY 13210-2342 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2007 |
Last Update Date | 21/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03347940 | (05) | NY |