Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | F401137-1 | NY |
NPI | 1003051368 |
---|---|
Provider Name | Mr. V. Thomas Chapin |
First Address | Tonawanda, NY 14150-3952 |
Second Address | Buffalo, NY 14215-3021 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2008 |
Last Update Date | 15/12/2008 |