Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2082S0105X | Plastic Hand Surgeon | 16040101 | NY |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 16040101 | NY |
NPI | 1689660508 |
---|---|
Provider Name | Jonathan Aaron Graff |
First Address | Williamsville, NY 14221-5411 |
Second Address | Williamsville, NY 14221-5411 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2005 |
Last Update Date | 23/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F14312 | (02) |