Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 35.138105 | OH |
N | 208000000X | Pediatrician | 35.138105 | OH |
N | 2080P0207X | Pediatric Hematology-Oncologist | 35.138105 | OH |
NPI | 1053675587 |
---|---|
Provider Name | Dr. Harry Lesmana |
First Address | Cincinnati, OH 45229-3026 |
Second Address | Cleveland, OH 44195-3026 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2012 |
Last Update Date | 07/07/2020 |