Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 082792 | NY |
NPI | 1790825081 |
---|---|
Provider Name | Wallace B Lehman |
First Address | New York, NY 10021-1192 |
Second Address | New York, NY 10003-3804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00499409 | (05) | NY |
B02803 | (02) |