MEDICARE: DR. HAROLD LIFSHUTZ PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103G00000X	Clinical Neuropsychologist	8003-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609810829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAROLD LIFSHUTZ PHD

Provider Business Mailing Address
First Line	:	41 CHATHAM RD
Second Line	:
City	:	NEW ROCHELLE
State	:	NY
Zip	:	10804-2535
Country	:	US
Telephone Number	:	914-654-8763
Fax Number	:

Provider Business Practice Location Address
First Line	:	19WEST 34TH ST
Second Line	:	PENTHOUSE SUITES
City	:	NEW YORK CITY
State	:	NY
Zip	:	10001
Country	:	US
Telephone Number	:	914-654-8763
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	02/23/2015

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