Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 164757 | NY |
NPI | 1013966720 |
---|---|
Provider Name | John Crane |
First Address | Buffalo, NY 14215-3021 |
Second Address | Buffalo, NY 14215-3021 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2006 |
Last Update Date | 22/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00010037401 | EXCELLUS UNIVERA (01) | NY |
005232271 | HEALTH NOW (01) | NY |
01464731 | (05) | NY |
3407600 | INDEPENDENT HEALTH (01) | NY |
E69205 | (02) | NY |