Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 200473 | NY |
NPI | 1063400521 |
---|---|
Provider Name | Elizabeth Love |
First Address | Cheektowaga, NY 14227-1465 |
Second Address | Orchard Park, NY 14127-4841 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2005 |
Last Update Date | 13/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00010306305 | UNIVERA (01) | NY |
000508352006 | BC/BS (01) | NY |
01761820 | (05) | NY |
10174010 | FIDELIS (01) | NY |
151124EL | PREFERRED CARE (01) | NE |
3000947 | IHA (01) | NY |
G49536 | (02) |