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General NPI Number Information
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NPI Number | 1003053539
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Entity Type | Organization
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Legal Business Name | THOMAS A. LALLAS, MD, PC
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Dates
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Enumeration Date | 01/21/2009
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Last Update Date | 01/21/2009
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Provider Practice Location Address
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Address Line | 907 5TH AVE
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City | NEW YORK
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State | NY
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Zip | 10021-4156
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Country | US
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Telephone | 212-838-0886
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Fax | 212-327-0526
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Provider Business Mailing Address
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Address Line | 907 5TH AVE
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City | NEW YORK
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State | NY
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Zip | 10021-4156
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Country | US
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Telephone | 212-838-0886
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Fax | 212-327-0526
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS A LALLAS
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Credential | M.D.
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Telephone | 212-838-0886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number |
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License Number State |
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