Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 206727 | NY |
NPI | 1083685028 |
---|---|
Provider Name | Lee M Krug |
First Address | New York, NY 10017-6706 |
Second Address | New York, NY 10021-6007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2006 |
Last Update Date | 06/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H12229 | (02) |