Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | S4651 | TX |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | S4651 | TX |
NPI | 1316326432 |
---|---|
Provider Name | Dr. Marissa Purcelli Lafer |
First Address | New York, NY 10065-7215 |
Second Address | New York, NY 10065-7215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2015 |
Last Update Date | 10/12/2021 |