Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0101X | MOHS-Micrographic Surgeon | 213486 | NY |
NPI | 1356341432 |
---|---|
Provider Name | Aza Lefkowitz |
First Address | New Hyde Park, NY 11040-2810 |
Second Address | Fresh Meadows, NY 11365-2201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2005 |
Last Update Date | 07/08/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02193617 | (05) | NY |
H32412 | (02) |