Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 188339 | NY |
NPI | 1053442400 |
---|---|
Provider Name | Edna R Lord |
First Address | Westbury, NY 11590-1740 |
Second Address | Plainview, NY 11803-4914 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01427605 | (05) | NY |
F65055 | (02) |