Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 026837 | NY |
NPI | 1083697577 |
---|---|
Provider Name | Michael H Braff |
First Address | Schenectady, NY 12308-2318 |
Second Address | Schenectady, NY 12308-2318 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00358690 | (05) | NY |