Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 200838 | NY |
NPI | 1043372022 |
---|---|
Provider Name | Gregory Lee |
First Address | New York, NY 10016 |
Second Address | New York, NY 10016-9196 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2006 |
Last Update Date | 09/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G48208 | (02) | NY |