Coburn, Emerth Lance

Coburn, Emerth Lance is an sole proprietor health care provider with primary practice located at 21401 110Th Ave , Queens Village NY 11429-1906. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Coburn, Emerth Lance can be contacted via phone (929) 615-6447.

Contact Information

Primary practice address
21401 110Th Ave Queens Village NY 11429-1906
Phone: (929) 615-6447
Fax: (718) 276-4783
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 198832 New York
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 198832 New York

Profile Details

NPI number 1477544096
LBN Legal business name Coburn, Emerth Lance
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 2nd, 2005
Last updated Mar 5th, 2025 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477544096 NPPES
New York MEDICAID 01617674

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