Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 25MA61328 | NJ |
N | 207RI0011X | Interventional Cardiology | 25MA61328 | NJ |
N | 207U00000X | Nuclear Medicine Specialist | 25MA61328 | NJ |
NPI | 1457335309 |
---|---|
Provider Name | Peter Lenchur |
First Address | Roselle, NJ 07203-1698 |
Second Address | Roselle, NJ 07203-1698 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2005 |
Last Update Date | 22/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8745803 | (05) | NJ |
G94430 | (02) |