MEDICARE: LEE POHLMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	67566	NY

General Provider Information

NPI Number	:	1467848523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEE POHLMAN

Provider Business Mailing Address
First Line	:	40 MORNINGSIDE AVE
Second Line	:	APT 34
City	:	NEW YORK
State	:	NY
Zip	:	10026-1020
Country	:	US
Telephone Number	:	419-296-1833
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 MORNINGSIDE AVE
Second Line	:	APT 34
City	:	NEW YORK
State	:	NY
Zip	:	10026-1020
Country	:	US
Telephone Number	:	419-296-1833
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2015
Last Update Date	:	04/15/2015

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Directions to “ LEE POHLMAN ” Practice Location

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