Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 260606 | NY |
NPI | 1003041187 |
---|---|
Provider Name | Dr. Andrew Robert Poreda |
First Address | Buffalo, NY 14202-2211 |
Second Address | Buffalo, NY 14203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2009 |
Last Update Date | 17/09/2014 |