Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 105616 | NY |
NPI | 1003825225 |
---|---|
Provider Name | Dr. Lawrence Joseph Minei |
First Address | Patchoque, NY 11772 |
Second Address | Patchoque, NY 11772 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00506450 | (05) | NY |
B78431 | (02) |