Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 310679 | NY |
NPI | 1457745044 |
---|---|
Provider Name | Gregory Pace |
First Address | Hudson, NY 12534-3815 |
Second Address | Hudson, NY 12534-3815 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2015 |
Last Update Date | 03/12/2021 |