1952382855 NPI number — LENOX HILL MEDICAL ASSOCIATES, PLLC

Table of content: (NPI 1952382855)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952382855 NPI number — LENOX HILL MEDICAL ASSOCIATES, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LENOX HILL MEDICAL ASSOCIATES, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952382855
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/09/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 9619
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UNIONDALE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11555-9619
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
770-693-2622
Provider Business Mailing Address Fax Number:
770-693-6039

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
61 E 77TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10075-1817
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-722-2130
Provider Business Practice Location Address Fax Number:
212-722-2147
Provider Enumeration Date:
11/08/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BERSON
Authorized Official First Name:
ANTHONY
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
212-722-2130

Provider Taxonomy Codes

  • Taxonomy code: 2085R0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com