Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0208X | Pediatric Infectious Diseases | 236318 | NY |
Y | 2080P0208X | Pediatric Infectious Diseases | MD12952 | RI |
NPI | 1326266800 |
---|---|
Provider Name | Elizabeth Dufort |
First Address | Albany, NY 12208-3412 |
Second Address | Albany, NY 12208-3412 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 17/10/2012 |