Provider Demographics
NPI:1891834354
Name:LEFKOWITZ, JAN EVAN (DC)
Entity type:Individual
Prefix:DR
First Name:JAN
Middle Name:EVAN
Last Name:LEFKOWITZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 W 45TH ST STE 1002
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-4212
Mailing Address - Country:US
Mailing Address - Phone:212-371-5788
Mailing Address - Fax:212-697-2725
Practice Address - Street 1:2 W 45TH ST STE 1002
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-4212
Practice Address - Country:US
Practice Address - Phone:212-371-5788
Practice Address - Fax:212-697-2725
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010193111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU96209Medicare UPIN
NYX6G181Medicare ID - Type Unspecified