Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 012609 | NY |
Y | 111NR0200X | Radiology | 012609 | NY |
Y | 213ER0200X | Radiology | 012609 | NY |
NPI | 1386042448 |
---|---|
Provider Name | Dr. Eric Timothy Stefanowicz |
First Address | Buffalo, NY 14201-1032 |
Second Address | Buffalo, NY 14201-1032 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2014 |
Last Update Date | 06/05/2019 |