Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 276100 | NY |
N | 2080P0204X | Pediatric Emergency Doctor | 276100 | NY |
NPI | 1285894907 |
---|---|
Provider Name | Dr. Ryan Kenneth Breuer |
First Address | Buffalo, NY 14203-1009 |
Second Address | Buffalo, NY 14203-1021 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2008 |
Last Update Date | 09/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03923475 | (05) | NY |