Healthcare Provider Details

I. General information

NPI: 1255511598
Provider Name (Legal Business Name): THADDEUS NAPRAWA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2007
Last Update Date: 11/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 MOUNT VIEW AVE BOX 252
WARSAW NY
14569-9555
US

IV. Provider business mailing address

36 MOUNT VIEW AVE BOX 252
WARSAW NY
14569-9555
US

V. Phone/Fax

Practice location:
  • Phone: 585-786-0239
  • Fax:
Mailing address:
  • Phone: 585-786-0239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number094174
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: