Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 289725 | NY |
NPI | 1093125809 |
---|---|
Provider Name | Lara El Khoury |
First Address | Great Neck, NY 11021-5310 |
Second Address | Great Neck, NY 11021-5310 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2014 |
Last Update Date | 25/04/2019 |