Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 40QA00721200 | NJ |
NPI | 1013083088 |
---|---|
Provider Name | Dr. Laurence Lim |
First Address | Paramus, NJ 07652-1632 |
Second Address | Hackensack, NJ 07601-1960 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 08/07/2007 |