Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 114116 | NY |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 114116 | NY |
NPI | 1255426441 |
---|---|
Provider Name | William Krause |
First Address | New Hartford, NY 13413 |
Second Address | New Hartford, NY 13413-4912 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 19/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
114116 | (05) | NY |
B81551 | (02) |