Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP1101X | Primary Podiatric Medicine | 25MD00283700 | NJ |
Y | 213EP1101X | Primary Podiatric Medicine | N006012 | NY |
NPI | 1629111521 |
---|---|
Provider Name | Dr. Jason Matthew Lacher |
First Address | Bronx, NY 10457-7606 |
Second Address | Bronx, NY 10457-7606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2007 |
Last Update Date | 04/03/2015 |