Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 138935 | NY |
NPI | 1679550370 |
---|---|
Provider Name | Dr. Kailash C Lall |
First Address | West Seneca, NY 14224-3352 |
Second Address | West Seneca, NY 14224-3352 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00637458 | (05) | NY |
B71664 | (02) | NY |