Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 209083 | NY |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 209083 | NY |
NPI | 1285648469 |
---|---|
Provider Name | Stephanie S Debuck |
First Address | Ithaca, NY 14850 |
Second Address | Ithaca, NY 14850 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 22/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01959306 | (05) | NY |
H00495 | (02) | NY |