Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 160077 | NY |
NPI | 1023116191 |
---|---|
Provider Name | Dr. Maria Teresa Lechuga |
First Address | Melville, NY 11747-4230 |
Second Address | Jamaica, NY 11418-2897 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01036557 | (05) | NY |
B13385 | (02) | NY |