MEDICARE: DR. JONATHAN LANZKOWSKY M.D.

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	207V00000X	Obstetrics & Gynecology Physician	201530	NY

General Provider Information

NPI Number	:	1780697961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN LANZKOWSKY M.D.

Provider Business Mailing Address
First Line	:	1107 FIFTH AVENUE
Second Line	:	SUITE1E
City	:	NEW YORK
State	:	NY
Zip	:	10128-0145
Country	:	US
Telephone Number	:	212-410-6700
Fax Number	:	212-722-3410

Provider Business Practice Location Address
First Line	:	1107 FIFTH AVENUE
Second Line	:	SUITE 1E
City	:	NEW YORK
State	:	NY
Zip	:	10128-0145
Country	:	US
Telephone Number	:	212-410-6700
Fax Number	:	212-722-3410

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

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	07/21/2022

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