Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 255563 | NY |
NPI | 1013156348 |
---|---|
Provider Name | Robert Lunn |
First Address | Binghamton, NY 13905 |
Second Address | Binghamton, NY 13905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2009 |
Last Update Date | 28/06/2010 |