Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 307782 | NY |
NPI | 1013362698 |
---|---|
Provider Name | Eliud Kosgei |
First Address | Buffalo, NY 14201-2398 |
Second Address | Buffalo, NY 14201-2398 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2016 |
Last Update Date | 08/07/2016 |