Provider Demographics
| NPI: | 1740222181 |
|---|---|
| Name: | LHHN MEDICAL, P.C. |
| Entity type: | Organization |
| Organization Name: | LHHN MEDICAL, P.C. |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | AVP - CREDENTIALING |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | MARLENA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | SIMPSON |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | CPMSM |
| Authorized Official - Phone: | 646-680-2894 |
| Mailing Address - Street 1: | 441 9TH AVE |
| Mailing Address - Street 2: | 9TH FLOOR |
| Mailing Address - City: | NEW YORK |
| Mailing Address - State: | NY |
| Mailing Address - Zip Code: | 10001-1623 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 646-680-2894 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 441 9TH AVE |
| Practice Address - Street 2: | 9TH FLOOR |
| Practice Address - City: | NEW YORK |
| Practice Address - State: | NY |
| Practice Address - Zip Code: | 10001-1623 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 646-680-2894 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-06-11 |
| Last Update Date: | 2015-06-04 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 207K00000X | Allopathic & Osteopathic Physicians | Allergy & Immunology | Group - Multi-Specialty | |
| No | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | Group - Multi-Specialty | |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
| No | 207W00000X | Allopathic & Osteopathic Physicians | Ophthalmology | Group - Multi-Specialty | |
| No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
| No | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | Group - Multi-Specialty | |
| No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
| No | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Multi-Specialty |
| No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
| No | 208800000X | Allopathic & Osteopathic Physicians | Urology | Group - Multi-Specialty | |
| No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
| No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
| No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| NY | 02215938 | Medicaid | |
| NY | W7Z761 | Medicare PIN |