Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 175695-1 | NY |
NPI | 1083662043 |
---|---|
Provider Name | Dr. Jeffrey Frost |
First Address | Getzville, NY 14068-1219 |
Second Address | Williamsville, NY 14221-2700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 12/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01348374 | (05) | NY |
F24215 | (02) |