Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 277117-1 | NY |
NPI | 1780845545 |
---|---|
Provider Name | Lesley Rabach |
First Address | New York, NY 10003-4377 |
Second Address | New York, NY 10003-4377 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2008 |
Last Update Date | 27/05/2016 |