Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 003816 | NY |
Y | 222Z00000X | Podiatrist | 003816 | NY |
NPI | 1063593630 |
---|---|
Provider Name | Dr. Jeffrey A Todd |
First Address | Norwich, NY 13815-3272 |
Second Address | Norwich, NY 13815-1741 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T26612 | (02) | NY |