Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 228001 | MA |
Y | 207T00000X | Neurosurgeon | 261941 | NY |
NPI | 1023043114 |
---|---|
Provider Name | Lawrence S Chin |
First Address | Syracuse, NY 13210-1603 |
Second Address | Syracuse, NY 13210-1603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 17/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03374765 | (05) | NY |