Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 0101046485 | VA |
NPI | 1043203359 |
---|---|
Provider Name | Lawrence Stein |
First Address | Berwick, PA 18603-0468 |
Second Address | Arlington, VA 22202-1872 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2005 |
Last Update Date | 01/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6068782 | (05) | VA |
E88824 | (02) | VA |