Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 259216 | NY |
N | 207P00000X | Emergency Physician | ASO552489648 | NY |
NPI | 1013170745 |
---|---|
Provider Name | Risa L Farber-Heath |
First Address | Syracuse, NY 13210-2342 |
Second Address | Syracuse, NY 13210-2342 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2008 |
Last Update Date | 06/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03352265 | (05) | NY |