Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 193741 | NY |
NPI | 1003029398 |
---|---|
Provider Name | Dr. John A Sterba |
First Address | East Aurora, NY 14052-2233 |
Second Address | East Aurora, NY 14052-2233 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 26/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
193741 | LICENSE (01) | NY |
BS2994235 | DEA (01) | NY |
F16443 | (02) | NY |