Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 223872 | MA |
N | 208600000X | Surgeon | 223872 | MA |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 223872 | MA |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD433389 | PA |
NPI | 1053492959 |
---|---|
Provider Name | Abraham Lebenthal |
First Address | Brookline, MA 02445-6002 |
Second Address | Boston, MA 02115-6110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 20/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1021087210001 | (05) | PA |
I32306 | (02) | MA |