Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 181498 | NY |
Y | 2080P0216X | Pediatric Rheumatologist | 181498 | NY |
NPI | 1124013784 |
---|---|
Provider Name | Dr. Lewis Krata |
First Address | Brooklyn, NY 11201 |
Second Address | Brooklyn, NY 11201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2005 |
Last Update Date | 19/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01574987 | (05) | NY |
G10674 | (02) | NY |