Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 001903-1 | NY |
Y | 213ES0000X | Sports Medicine | 001903-1 | NY |
NPI | 1235518143 |
---|---|
Provider Name | Erin B Chapman |
First Address | Brockport, NY 14420-2997 |
Second Address | Brockport, NY 14420 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2015 |
Last Update Date | 26/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
090702205 | ATHLETIC TRAINER (01) | NY |