Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080N0001X | Neonatal-Perinatal Doctor | 053808 | CT |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 281882 | NY |
N | 2080N0001X | Neonatal-Perinatal Doctor | 33644 | DC |
NPI | 1033119953 |
---|---|
Provider Name | Dr. Tracy Lawrence-Black |
First Address | West Harrison, NY 10604-1126 |
Second Address | Valhalla, NY 10595-1637 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2005 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H83793 | (02) |