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NPI Code Detail

MEDICARE: DR. CLARA LEER-LUN AUTY M.D.

MEDICARE: DR. CLARA LEER-LUN AUTY M.D.
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
1207Q00000XFamily Medicine Physician222017NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17746384OTHERAETNA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
37700234OTHERUNITED HEALTH CARE
4000923270001OTHERNYHEALTHY NEW YORK
51070004BFOTHERPREFERRED CARE

General Provider Information

NPI Number : 1952350340
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CLARA LEER-LUN AUTY M.D.
Provider Business Mailing Address
First Line : 369 VALLEY BROOK DR
Second Line :
City : LEXINGTON
State : KY
Zip : 40511-8782
Country : US
Telephone Number : 859-402-2159
Fax Number :
Provider Business Practice Location Address
First Line : 650 NEWTOWN PIKE
Second Line :
City : LEXINGTON
State : KY
Zip : 40508-1113
Country : US
Telephone Number : 859-252-2371
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2006
Last Update Date : 07/09/2007

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