Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 34-008803 | OH |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 34.008803 | OH |
N | 207YS0123X | Facial Plastic Surgeon | OS10415 | FL |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 270541 | NY |
NPI | 1922031004 |
---|---|
Provider Name | Mr. Nicholas Richard Groch |
First Address | Oswego, NY 13126-2525 |
Second Address | Oswego, NY 13126-2525 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2006 |
Last Update Date | 13/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000486232 | ANTHEM (01) | OH |
06184 | PARAMOUNT (01) | OH |
2669189 | (05) | OH |
4186141 | (02) | OH |
7268808 | AETNA (01) | OH |
I55591 | (02) | OH |
P00358244 | RRMC (01) | OH |