Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 109414 | NY |
NPI | 1285930941 |
---|---|
Provider Name | Dr. James Joseph White JR. |
First Address | Buffalo, NY 14209-1635 |
Second Address | Buffalo, NY 14209-1635 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2011 |
Last Update Date | 28/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
COS 109414-3B | WORKERS' COMPENSATION BOARD NUMBER (01) | NY |