Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 126764-1 | NY |
Y | 208600000X | Surgeon | 126764-1 | NY |
N | 2082S0105X | Plastic Hand Surgeon | 126764-1 | NY |
NPI | 1700884921 |
---|---|
Provider Name | J Webster Stayman III |
First Address | Oneonta, NY 13820-2027 |
Second Address | Oneonta, NY 13820-2027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2005 |
Last Update Date | 15/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10032783 | CDPHP (01) | |
242002305 | TRAVELERS RAILROAD MEDICA (01) | |
D74005 | (02) | NY |