Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 304556 | NY |
N | 207K00000X | Allergist & Immunologist | 62057 | CO |
N | 207RA0201X | Internist - Allergy & Immunology | DR.0062057 | CO |
NPI | 1144649260 |
---|---|
Provider Name | Dr. Lorelei Natasha Bourla |
First Address | Saratoga Springs, NY 12866-3073 |
Second Address | Saratoga Springs, NY 12866-3073 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2014 |
Last Update Date | 16/09/2020 |