Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 145680 | NY |
NPI | 1023037355 |
---|---|
Provider Name | Dr. William J Kingston |
First Address | Canandaigua, NY 14424-1788 |
Second Address | Canandaigua, NY 14424-1788 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 16/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00717657 | (05) | NY |
B72499 | (02) | NY |