Carrasco, Lee R
Carrasco, Lee R is an individual health care provider with primary practice located at 3400 Spruce Street 5 White Building, Philadelphia PA 19104. He recently has only one registered license in Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, which is considered as his primary health care specialty. Carrasco, Lee R can be contacted via phone (215) 662-3580.Contact Information
Primary practice address
3400 Spruce Street 5 White Building
Philadelphia PA 19104
Phone: (215) 662-3580
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | MD418924 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | DS031585L | Pennsylvania |
Profile Details
| NPI number | 1013946540 |
|---|---|
| LBN Legal business name | Carrasco, Lee R |
| Credentials | MD DDS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 2006 |
| Last updated | Apr 10th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013946540 | NPPES |
| Pennsylvania | MEDICAID | 0018942480001 |
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