Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 219131 | MA |
N | 111NI0900X | Internist | 219131 | MA |
N | 207R00000X | Internist | D0063734 | MD |
N | 111NI0900X | Internist | D0063734 | MD |
N | 207R00000X | Internist | MD13131 | HI |
N | 111NI0900X | Internist | MD13131 | HI |
N | 207R00000X | Internist | MD425365 | PA |
N | 111NI0900X | Internist | MD425365 | PA |
Y | 207RH0003X | Hematology & Oncology | 0101242990 | VA |
NPI | 1003882432 |
---|---|
Provider Name | Dr. Lee Resta |
First Address | Winchester, VA 22601-6906 |
Second Address | Winchester, VA 22601-6906 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2006 |
Last Update Date | 28/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I07675 | (02) |