Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | F334121 | NY |
NPI | 1366417198 |
---|---|
Provider Name | Brenda Fix |
First Address | Buffalo, NY 14267-0002 |
Second Address | Buffalo, NY 14203-1126 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02429481 | (05) | NY |