Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 020888 | NY |
N | 208600000X | Surgeon | 020888 | NY |
NPI | 1003338278 |
---|---|
Provider Name | Leah Kidder |
First Address | Dansville, NY 14437-0601 |
Second Address | Cohocton, NY 14826-9401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2017 |
Last Update Date | 13/10/2021 |