Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 087763-1 | NY |
NPI | 1346248960 |
---|---|
Provider Name | Dr. Leonard Freeman |
First Address | New York, NY 10022-4167 |
Second Address | Bronx, NY 10467-2401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00138087 | (05) | NY |
CO6442 | (02) |