Individual
MARY LOUISE LENAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
153446-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010102801
UNIVERA
NY
01
—
000500619001
BCBS OF WNY
NY
01
—
0301329
IHA
NY
Enumeration date
09/27/2005
Last updated
05/20/2019
Update your record
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