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1578693040
MICHAEL ROGER LACE
BRONX, NY
NPI
1578693040
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NY 009906)
Enumeration Date
2007-03-06
Last Update Date
2007-07-08
Business Address
Mr. MICHAEL ROGER LACE PA
111 E 210TH ST
BRONX, NY 10467-2401
Phone number: 718-920-5795
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Mailing Address
Mr. MICHAEL ROGER LACE PA
49 IROQUOIS DR
BRIGHTWATERS, NY 11718-1210
Phone number: 516-380-7088
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