Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 146425-1 | NY |
Y | 208600000X | Surgeon | 146425-1 | NY |
NPI | 1003884545 |
---|---|
Provider Name | Timothy J Huddle |
First Address | Montour Falls, NY 14865-9740 |
Second Address | Montour Falls, NY 14865-9740 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2006 |
Last Update Date | 08/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00937077 | (05) | NY |
B81380 | (02) | NY |