Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 143135 | NY |
N | 111NI0900X | Internist | 143135 | NY |
Y | 207RH0000X | Hematologist | 143135 | NY |
NPI | 1104840495 |
---|---|
Provider Name | Jeffrey Buckner |
First Address | New York, NY 10016 |
Second Address | New York, NY 10016-0701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 07/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D47792 | (02) | NY |