Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | MD023282E | PA |
Y | 207RH0003X | Hematology & Oncology | MD023282E | PA |
N | 207RX0202X | Medical Oncology | MD023282E | PA |
NPI | 1033153937 |
---|---|
Provider Name | Lawrence Fisher Brass |
First Address | Philadelphia, PA 19104-5127 |
Second Address | Philadelphia, PA 19104-5127 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 22/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0006612790001 | (05) | PA |
C30817 | (02) |