Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RR0500X | Rheumatology | 0101049859 | VA |
Y | 207RR0500X | Rheumatology | 050826 | CT |
N | 2080P0216X | Pediatric Rheumatologist | 050826 | CT |
NPI | 1932298098 |
---|---|
Provider Name | Dr. Lenore M Buckley |
First Address | New Haven, CT 06519-1612 |
Second Address | New Haven, CT 06519-1612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 06/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006003893 541581185 | (05) | VA |
B73970 | (02) |