Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 150203 | NY |
NPI | 1174544860 |
---|---|
Provider Name | Dr. Bruce Rodgers |
First Address | Buffalo, NY 14214-2648 |
Second Address | Buffalo, NY 14214-2648 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 22/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D01443 | (02) | NY |