Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | 300754 | NY |
Y | 208000000X | Pediatrician | 300754 | NY |
NPI | 1689028425 |
---|---|
Provider Name | Dr. Timothy John Bright |
First Address | Syracuse, NY 13210-2306 |
Second Address | Syracuse, NY 13210-2306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2016 |
Last Update Date | 05/03/2020 |