Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 269255 | NY |
N | 208600000X | Surgeon | 269255 | NY |
Y | 2082S0105X | Plastic Hand Surgeon | 269255 | NY |
NPI | 1134379902 |
---|---|
Provider Name | David Anthony Graham |
First Address | Victor, NY 14564-1419 |
Second Address | Victor, NY 14564-1419 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2008 |
Last Update Date | 13/09/2016 |