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General NPI Number Information
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NPI Number | 1194783704
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Entity Type | Individual
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Provider Name | PAULINE LESAGE MD
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Gender | Female
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 09/25/2012
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Provider Practice Location Address
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Address Line | 10 UNION SQUARE EAST BIMC DEPT OF PAIN & PALLIATIVE CARE
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City | NEW YORK
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State | NY
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Zip | 10003
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Country | US
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Telephone | 212-844-1487
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 95000-2435
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City | PHILADELPHIA
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State | PA
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Zip | 19195-2435
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Country | US
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Telephone | 212-844-1499
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 213868
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License Number State | NY
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