Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 254078 | NY |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 254078 | NY |
NPI | 1326207556 |
---|---|
Provider Name | Dr. Samuel Greenwood Dellenbaugh |
First Address | Albany, NY 12205-1447 |
Second Address | Albany, NY 12205-1447 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2008 |
Last Update Date | 08/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
254078 | LICENSE (01) | NY |