Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | MA055534 | NJ |
NPI | 1073567897 |
---|---|
Provider Name | Dr. Mark Lehman |
First Address | Freehold, NJ 07728-2974 |
Second Address | Freehold, NJ 07728-2974 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C05330 | (02) | NJ |