Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 281811 | NY |
Y | 207YP0228X | Pediatric Otolaryngology | 281811 | NY |
NPI | 1407172174 |
---|---|
Provider Name | John Joseph Faria |
First Address | Rochester, NY 14618-2663 |
Second Address | Rochester, NY 14618-2663 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2010 |
Last Update Date | 20/07/2016 |