Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MD069361L | PA |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | MD069361L | PA |
NPI | 1215933502 |
---|---|
Provider Name | Eric B Lebby |
First Address | Allentown, PA 18105-1754 |
Second Address | Allentown, PA 18103-6224 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2005 |
Last Update Date | 29/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0019431730001 | (05) | PA |
H77037 | (02) | PA |