Provider Demographics
NPI:1699916957
Name:LF MEDICAL SERVICES OF NY,PC
Entity type:Organization
Organization Name:LF MEDICAL SERVICES OF NY,PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DERECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LAZAR
Authorized Official - Middle Name:I
Authorized Official - Last Name:FEYGIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-942-4984
Mailing Address - Street 1:424 LAFAYETTE AVE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-1694
Mailing Address - Country:US
Mailing Address - Phone:718-942-4984
Mailing Address - Fax:718-942-4987
Practice Address - Street 1:424 LAFAYETTE AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-1694
Practice Address - Country:US
Practice Address - Phone:718-942-4984
Practice Address - Fax:718-942-4987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-17
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205549207R00000X
NY212904207R00000X
NY248694207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01905751Medicaid
NY01786149Medicaid
NY58X161Medicare PIN
NY01905751Medicaid