Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 245852 | NY |
Y | 207RP1001X | Pulmonary Disease | 245852 | NY |
NPI | 1033156336 |
---|---|
Provider Name | Todd Sheppard |
First Address | Rochester, NY 14621-3001 |
Second Address | Rochester, NY 14621-3001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 31/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02859185 | (05) | NY |