Individual
LOGAN LAURENCE BARTRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17 E 102ND ST, NEW YORK, NY 10029-5204
(212) 241-7968
Mailing address
150 E 42ND ST FL 9, NEW YORK, NY 10017-5699
(646) 605-8186
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
294431
NY
207RI0200X
Infectious Disease Physician
Primary
294431
NY
Other
Enumeration date
04/07/2015
Last updated
07/06/2020
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