Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 210151 | NY |
N | 207NP0225X | Pediatric Dermatologist | 210151 | NY |
N | 207NS0135X | Procedural Dermatology | 210151 | NY |
NPI | 1467416768 |
---|---|
Provider Name | Dr. Michael Benjamin Bobrow |
First Address | Rochester, NY 14626-3919 |
Second Address | Rochester, NY 14626-3919 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2006 |
Last Update Date | 16/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H15255 | (02) |