Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 0101028944 | VA |
N | 208600000X | Surgeon | 0101028944 | VA |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 0101028944 | VA |
NPI | 1093784498 |
---|---|
Provider Name | Dr. Edward A Lefrak |
First Address | Falls Church, VA 22042-1205 |
Second Address | Falls Church, VA 22042-1205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2006 |
Last Update Date | 06/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
031188500 | (05) | DC |
7496851 | (05) | VA |
E53233 | (02) | VA |