Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 121254 | NY |
NPI | 1043270457 |
---|---|
Provider Name | Dr. Thomas Lansen |
First Address | White Plains, NY 10604-2907 |
Second Address | White Plains, NY 10604-2907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2006 |
Last Update Date | 03/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C06791 | (02) | NY |