Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 119477 | NY |
N | 208800000X | Urologist | C51053 | CA |
NPI | 1043530843 |
---|---|
Provider Name | Dr. Lawrence Elliott Heller |
First Address | New York, NY 10128 |
Second Address | New York, NY 10128 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2010 |
Last Update Date | 15/01/2016 |