Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 016431 | CT |
NPI | 1477538205 |
---|---|
Provider Name | Dr. Thomas Henry Lesnik |
First Address | Norwich, CT 06360-2708 |
Second Address | Norwich, CT 06360-2708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010016431CT01 | ANTHEM BC/BS (01) | CO |
030800 | HEALTHNET (01) | |
502758 | AETNA (01) | CT |
B39313 | (02) | CT |