Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 292811 | NY |
Y | 208600000X | Surgeon | 292811 | NY |
N | 208200000X | Surgeon | 35.130486 | OH |
N | 208600000X | Surgeon | 35.130486 | OH |
N | 2086S0127X | Trauma Surgeon | 03613822 | IL |
NPI | 1366701229 |
---|---|
Provider Name | Theadore A Hufford JR. |
First Address | Brooklyn, NY 11212-3139 |
Second Address | Brooklyn, NY 11236-3726 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2012 |
Last Update Date | 28/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
292811 | LICENSE (01) | NY |