Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 141264 | NY |
NPI | 1073672762 |
---|---|
Provider Name | Dr. Theodore Henry Lenox III |
First Address | New York, NY 10029 |
Second Address | New York, NY 10029 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00734143 | (05) | NY |
E44638 | (02) | NY |