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1316081581
DEREK LEZAMA
BROOKLYN, NY
NPI
1316081581
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
111NR0400X
(Licence: NY 007667)
Enumeration Date
2007-02-19
Last Update Date
2007-07-08
Business Address
Dr. DEREK LEZAMA
5455 KINGS HWY
BROOKLYN, NY 11203-6040
Phone number: 718-629-4020
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Mailing Address
Dr. DEREK LEZAMA
5455 KINGS HWY
BROOKLYN, NY 11203-6040
Phone number: 718-629-4020
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