Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | 141376 | NY |
NPI | 1154387868 |
---|---|
Provider Name | Dr. Donald Joseph Nenno II |
First Address | Buffalo, NY 14202 |
Second Address | Buffalo, NY 14209-2412 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2006 |
Last Update Date | 28/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00480979 | (05) | NY |
B71640 | (02) | NY |