Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 15098 | CT |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 15098 | CT |
NPI | 1780670570 |
---|---|
Provider Name | Dr. Richard J. Lessow |
First Address | Hartford, CT 06106-5501 |
Second Address | Hartford, CT 06106-5501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B37764 | (02) | CT |