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Individual
MARY JOAN LOCKWOOD
Active
Individual
MARY JOAN LOCKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
300840
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01499141
—
NY
01
—
019300840
BLUE CHOICE
NY
01
—
109711BJ
PREFERRED CARE
NY
Enumeration date
03/30/2006
Last updated
03/08/2012
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