Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VE0102X | Reproductive Endocrinologist | 237929 | NY |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 237929-1 | NY |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD438097 | PA |
NPI | 1104815679 |
---|---|
Provider Name | Jay M Bolnick |
First Address | West Seneca, NY 14224-4658 |
Second Address | West Seneca, NY 14224-4658 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2005 |
Last Update Date | 11/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03222671 | (05) | NY |
D28972 | (02) | CT |