Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 266692 | NY |
Y | 2080P0214X | Pediatric Pulmonologist | 266692 | NY |
NPI | 1053365452 |
---|---|
Provider Name | Danielle Marie Goetz |
First Address | Buffalo, NY 14203-1009 |
Second Address | Buffalo, NY 14203-1009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2006 |
Last Update Date | 23/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02760841 | (05) | NY |