Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | X009764 | NY |
N | 111NN1001X | Nutrition | X009764 | NY |
N | 111NR0200X | Radiology | X009764 | NY |
N | 213ER0200X | Radiology | X009764 | NY |
N | 111NT0100X | Thermography | X009764 | NY |
NPI | 1649345554 |
---|---|
Provider Name | Dr. Jessica D'amore-Przybylak |
First Address | Snyder, NY 14226-4707 |
Second Address | Snyder, NY 14226-4709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2006 |
Last Update Date | 09/07/2007 |