Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 242664 | NY |
NPI | 1053323097 |
---|---|
Provider Name | Patrick J. Reid |
First Address | Rochester, NY 14626-4296 |
Second Address | Rochester, NY 14626-4296 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 09/02/2015 |