Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 253736-1 | NY |
N | 207VX0000X | Obstetrician | 48600 | MN |
NPI | 1306858188 |
---|---|
Provider Name | Courtenay L Diehl |
First Address | Batavia, NY 14020-1684 |
Second Address | Batavia, NY 14020-1684 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2006 |
Last Update Date | 05/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03124816 | (05) | NY |
I57724 | (02) |