Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 170657 | NY |
Y | 2080P0201X | Pediatric Allergist | 170657 | NY |
NPI | 1902873839 |
---|---|
Provider Name | Dr. Jeffrey Bruce Rockoff |
First Address | Amherst, NY 14226-3822 |
Second Address | Buffalo, NY 14222-2006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2006 |
Last Update Date | 08/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00010149202 | UNIVERA (01) | |
000510237002 | BC/BS (01) | |
0018613270001 | (05) | PA |
01048255 | (05) | NY |
0203578 | IHA (01) | |
040426001896 | FIDELIS (01) | |
E55338 | (02) | NY |