Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 121353-1 | NY |
NPI | 1053344648 |
---|---|
Provider Name | Dr. John Bell-Thomson |
First Address | East Aurora, NY 14052-9691 |
Second Address | East Aurora, NY 14052-9691 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2006 |
Last Update Date | 21/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B09925 | (02) | NY |