Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 124408 | NY |
Y | 208600000X | Surgeon | 124408 | NY |
N | 2082S0105X | Plastic Hand Surgeon | 124408 | NY |
NPI | 1710992466 |
---|---|
Provider Name | Dr. Bruce Berner Shafiroff |
First Address | Cicero, NY 13039-8715 |
Second Address | Syracuse, NY 13210-1756 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2006 |
Last Update Date | 24/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00480511 | (05) | NY |
B82965 | (02) | NY |