Keron Lezama, M.D.
Student in an Organized Health Care Education/Training Program in Bronx, NY. Individual provider (NPI-1).
NPI number1295098564
StatusActive
Last updated in NPPESJun 20, 2012
Details
- NPI
- 1295098564
- Entity type
- Individual (NPI-1)
- Name
- Keron Lezama
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 20, 2012
- Last updated
- Jun 20, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
111 E 210th StBronx, NY 10467-2401
Phone 718-920-4321
Mailing address
100 Haven AveApt 23d
New York, NY 10032-2645
Phone 617-447-4718
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