Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | 227753 | NY |
Y | 2080P0204X | Pediatric Emergency Doctor | 227753 | NY |
NPI | 1659326221 |
---|---|
Provider Name | Lynn Marie Lawrence |
First Address | Amherst, NY 14226-3822 |
Second Address | Buffalo, NY 14222-2006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 31/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00027536201 | UNIVERA (01) | |
000528533001 | BC/BS (01) | |
02747419 | (05) | NY |
060707000000 | FIDELIS (01) | |
1213247 | IHA (01) | |
I51768 | (02) |