Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 097133-1 | NY |
NPI | 1245208354 |
---|---|
Provider Name | Michael Ray |
First Address | Buffalo, NY 14214-2648 |
Second Address | Buffalo, NY 14214-2648 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00010144901 | UNIVERA (01) | NY |
000503523001 | HEALTHNOW (01) | NY |
0703922 | INDEPENDENT HEALTH (01) | NY |
D01490 | (02) | |
PENDING | (05) | NY |