Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 269623 | NY |
Y | 207RP1001X | Pulmonary Disease | 269623 | NY |
NPI | 1063654135 |
---|---|
Provider Name | Deirdre Colgan |
First Address | Rochester, NY 14617-5504 |
Second Address | Newark, NY 14513-1090 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2009 |
Last Update Date | 27/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04464600 | (05) | NY |