Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | X3832 | NY |
NPI | 1467474221 |
---|---|
Provider Name | Dr. Lauren Roberts |
First Address | Brooklyn, NY 11222-2989 |
Second Address | Brooklyn, NY 11222-2989 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T52583 | (02) | NY |