Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 280878 | NY |
N | 204F00000X | Transplant Surgeon | 36718 | AZ |
N | 208200000X | Surgeon | 280878 | NY |
N | 208600000X | Surgeon | 280878 | NY |
N | 208200000X | Surgeon | 33689 | MN |
N | 208600000X | Surgeon | 33689 | MN |
NPI | 1487725917 |
---|---|
Provider Name | Dr. Rainer W Gruessner |
First Address | Syracuse, NY 13210 |
Second Address | Syracuse, NY 13210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 31/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0060697 | (05) | MT |
0977264 | (05) | IA |
1009125 | PREFERREDONE (01) | |
101022 | UCARE (01) | |
1712215 | MEDICA - CHOICE (01) | |
1712215 | MEDICA - PRIMARY (01) | |
213545 | (05) | AZ |
2T096GR | BLUE CROSS BLUE SHIELD (01) | |
690580300 | (05) | MN |
763592 | ARAZ (01) | |
E97470 | (02) | |
HP22171 | HEALTHPARTNERS (01) | |
P00435421 | RAILROAD MEDICARE (01) | AZ |