Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | X006142 | NY |
NPI | 1912130345 |
---|---|
Provider Name | Robert Lockey |
First Address | Brooklyn, NY 11238 |
Second Address | Brooklyn, NY 11238-6300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2009 |
Last Update Date | 02/09/2009 |