Basic Information
| Provider Information | |||||||||
| NPI: | 1477687762 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEMON-MULE | ||||||||
| FirstName: | HEATHER | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 704 166TH ST | ||||||||
| Address2: | APT 4B | ||||||||
| City: | WHITESTONE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113572058 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183430155 | ||||||||
| FaxNumber: | 7189603792 | ||||||||
| Practice Location | |||||||||
| Address1: | 4422 3RD AVE | ||||||||
| Address2: | DEPARTMENT OF PEDIATRICS, ST. BARNABAS HOSPITAL | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104572545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189609331 | ||||||||
| FaxNumber: | 7189603792 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2007 | ||||||||
| LastUpdateDate: | 02/19/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 236489 | NY | N | Allopathic & Osteopathic Physicians | Pediatrics | 207K00000X | 236489 | NY | Y | Allopathic & Osteopathic Physicians | Allergy & Immunology |
No ID Information.