Provider Demographics
NPI:1831243807
Name:ASTRAMED PHYSICIAN PC
Entity type:Organization
Organization Name:ASTRAMED PHYSICIAN PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:LAMONT
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-275-4029
Mailing Address - Street 1:19021 DORMANS RD
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:NY
Mailing Address - Zip Code:11412-2622
Mailing Address - Country:US
Mailing Address - Phone:718-454-7833
Mailing Address - Fax:718-454-6746
Practice Address - Street 1:19021 DORMANS RD
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11412-2622
Practice Address - Country:US
Practice Address - Phone:718-454-7833
Practice Address - Fax:718-454-6746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical GeneticsGroup - Multi-Specialty