Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 037092-1 | NY |
NPI | 1538224811 |
---|---|
Provider Name | Dr. Lawrence Bailey |
First Address | New York, NY 10026-1620 |
Second Address | New York, NY 10026-1620 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2006 |
Last Update Date | 17/08/2015 |