Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 276279 | NY |
NPI | 1356579940 |
---|---|
Provider Name | Paul Aaron Grant |
First Address | Buffalo, NY 14263-0001 |
Second Address | Buffalo, NY 14263-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2009 |
Last Update Date | 13/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04039185 | (05) | NY |