Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 164051 | NY |
NPI | 1033510755 |
---|---|
Provider Name | Dr. Jude Steven Sauer |
First Address | Victor, NY 14564-8966 |
Second Address | Victor, NY 14564-8966 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2014 |
Last Update Date | 12/09/2014 |