Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 204063 | NY |
N | 208200000X | Surgeon | 204063 | NY |
N | 208600000X | Surgeon | 204063 | NY |
NPI | 1003891128 |
---|---|
Provider Name | Dr. Frederick Huie |
First Address | Staten Island, NY 10301-2011 |
Second Address | Nyack, NY 10960-1912 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01958850 | (05) | NY |
G88894 | (02) | NY |