Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 171018 | NY |
N | 207V00000X | Obstetrician & Gynecologist | 171018 | NY |
NPI | 1023015625 |
---|---|
Provider Name | Dr. Edward Jerome Degnan |
First Address | Slingerlands, NY 12159-9564 |
Second Address | Slingerlands, NY 12159-9564 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2005 |
Last Update Date | 08/07/2007 |