NPI age
19 years
Enumerated 2006-10-19
Across 252 active pediatrics providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (NY) | 00717744 | |
| 01 (NY) | 100803DL | PREFERRED CARE |
| 01 (NY) | 5260652 | AETNA |
| 01 (NY) | P010132608 | EXCELLUS BC/BS ROCHESTER |
Part of a multi-provider practice. 8 other active providers share this practice address in NPPES.
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