Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 205258 | NY |
N | 208600000X | Surgeon | 205258 | NY |
Y | 208C00000X | Colorectal Surgeon | 205258 | NY |
NPI | 1013977495 |
---|---|
Provider Name | Mary Lou O'neill-Huber |
First Address | Rochester, NY 14623-4300 |
Second Address | Rochester, NY 14626-4605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2006 |
Last Update Date | 08/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01740234 | (05) | NY |
5795663 | AETNA (01) | NY |
G46591 | (02) | NY |
MDB767 | PREFERRED CARE (01) | NY |
P010205258 | BLUES (01) | NY |