Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 005636 | CT |
N | 363LP2300X | Nurse Practitioner - Primary Care | 338439-1 | NY |
NPI | 1003121674 |
---|---|
Provider Name | Wilmot Lambert |
First Address | Norwalk, CT 06851-1080 |
Second Address | Norwalk, CT 06851-1080 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2010 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003121674 | (05) | NC |
NP2780 | (05) | SC |