Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 239979 | NY |
NPI | 1003995903 |
---|---|
Provider Name | Tracy L Maier |
First Address | Rochester, NY 14617-5504 |
Second Address | Rochester, NY 14612-2349 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 11/02/2021 |