Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 142730 | NY |
Y | 208600000X | Surgeon | 142730 | NY |
NPI | 1013918044 |
---|---|
Provider Name | Lawrence Kerr |
First Address | Johnson City, NY 13790-2558 |
Second Address | Binghamton, NY 13903-1605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2005 |
Last Update Date | 19/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00605894 | (05) | NY |
B81012 | (02) |