Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RR0500X | Rheumatology | 241671 | NY |
Y | 2080P0216X | Pediatric Rheumatologist | 241671 | NY |
NPI | 1386656783 |
---|---|
Provider Name | Dr. Bethany Anne Marston |
First Address | Rochester, NY 14642-0001 |
Second Address | Rochester, NY 14642-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 23/05/2012 |