Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | F342319-1 | NY |
NPI | 1023529229 |
---|---|
Provider Name | Joshua Dawson |
First Address | Pittsford, NY 14534-4563 |
Second Address | Pittsford, NY 14534-4563 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2017 |
Last Update Date | 16/10/2017 |