Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | N005512 | NY |
NPI | 1063440147 |
---|---|
Provider Name | Dr. Beth Lisa Hommel-Hochstein |
First Address | Great Neck, NY 11021-2414 |
Second Address | Great Neck, NY 11021-2414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U74425 | (02) | NY |