Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | 023282 | NY |
NPI | 1154329910 |
---|---|
Provider Name | Harry Lumerman |
First Address | New York, NY 10029-6500 |
Second Address | New York, NY 10029-6500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2005 |
Last Update Date | 26/04/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T91503 | (02) | NY |