Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | 258011 | NY |
NPI | 1215183421 |
---|---|
Provider Name | Heather Marie Territo |
First Address | Buffalo, NY 14203-1009 |
Second Address | Buffalo, NY 14203-1021 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2008 |
Last Update Date | 20/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03584512 | (05) | NY |