Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 125051569 | IL |
NPI | 1003057779 |
---|---|
Provider Name | Dr. Mark Sieminski |
First Address | Cheektowaga, NY 14225-1980 |
Second Address | Cheektowaga, NY 14225-1980 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2009 |
Last Update Date | 20/10/2009 |