Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N006378-1 | NY |
NPI | 1124287271 |
---|---|
Provider Name | Catherine Nandzik |
First Address | Cicero, NY 13039-1768 |
Second Address | Vestal, NY 13850-3500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2008 |
Last Update Date | 11/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03301360 | (05) | NY |