Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | F3812241 | NY |
NPI | 1003871732 |
---|---|
Provider Name | Holly Joy Terzo |
First Address | Fairport, NY 14450 |
Second Address | Fairport, NY 14450 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2006 |
Last Update Date | 08/07/2007 |