Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 6876 | MD |
N | 1223D0001X | Dental Public Health | 6876 | MD |
Y | 1223G0001X | General Practice | 6876 | MD |
Y | 213EG0000X | General Practice | 6876 | MD |
NPI | 1144543554 |
---|---|
Provider Name | Dr. Paul Daniel Becker |
First Address | Saratoga Springs, NY 12866-6050 |
Second Address | Saratoga Springs, NY 12866-6050 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2010 |
Last Update Date | 04/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1144543554 | (05) | MD |