Provider Demographics
NPI:1790825081
Name:LEHMAN, WALLACE B (MD)
Entity Type:Individual
Prefix:
First Name:WALLACE
Middle Name:B
Last Name:LEHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2 EAST END AVE
Mailing Address - Street 2:PA F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-1192
Mailing Address - Country:US
Mailing Address - Phone:212-794-2043
Mailing Address - Fax:212-794-0380
Practice Address - Street 1:301 E 17TH ST
Practice Address - Street 2:NYU HOSPITAL FOR JOINT DISEASES SUITE 413
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3804
Practice Address - Country:US
Practice Address - Phone:212-598-6403
Practice Address - Fax:212-598-6084
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY082792207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00499409Medicaid
NY00499409Medicaid