Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 155353 | NY |
N | 2080A0000X | Adolescent Medicine | 155353 | NY |
Y | 2080P0216X | Pediatric Rheumatologist | 155353 | NY |
NPI | 1215962907 |
---|---|
Provider Name | Dr. David M Siegel |
First Address | Rochester, NY 14642-0001 |
Second Address | Rochester, NY 14642-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 24/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00831989 | (05) | NY |
I12218 | (02) |