Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 189482 | NY |
NPI | 1013088012 |
---|---|
Provider Name | Mark Safford |
First Address | Jamaica, NY 11432-1121 |
Second Address | Jamaica, NY 11432-1121 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 17/04/2013 |