Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0120X | Pediatric Surgery | 154741 | MA |
N | 2086S0120X | Pediatric Surgery | 19530 | NH |
Y | 2086S0120X | Pediatric Surgery | MD434491 | PA |
NPI | 1184682213 |
---|---|
Provider Name | Marc S Lessin |
First Address | Danville, PA 17822-4903 |
Second Address | Danville, PA 17822-9800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 04/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F87140 | (02) | GA |