Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 146166 | NY |
NPI | 1043288103 |
---|---|
Provider Name | Frederick C Morin III |
First Address | North Tonawanda, NY 14120-2019 |
Second Address | Williamsville, NY 14221-3647 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00645309 | (05) | NY |