Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 254528 | NY |
Y | 207VE0102X | Reproductive Endocrinologist | 254528 | NY |
NPI | 1154320083 |
---|---|
Provider Name | Frederick Sengstacke |
First Address | Syracuse, NY 13202-2240 |
Second Address | Syracuse, NY 13202-2240 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2005 |
Last Update Date | 22/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03223810 | (05) | NY |