Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | 217789 | NY |
NPI | 1174592448 |
---|---|
Provider Name | Dr. Wayne Shreffler |
First Address | New York, NY 10029-6500 |
Second Address | New York, NY 10029-6500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2006 |
Last Update Date | 07/09/2012 |