MEDICARE: DR. LARISSA LEMPERT 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	2084N0400X	Neurology Physician	244026	NY

General Provider Information

NPI Number	:	1912182619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LARISSA LEMPERT M.D.

Provider Business Mailing Address
First Line	:	736 AVE X
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-6121
Country	:	US
Telephone Number	:	718-874-0046
Fax Number	:	347-586-0036

Provider Business Practice Location Address
First Line	:	50 COURT ST
Second Line	:	STE 511
City	:	BROOKLYN
State	:	NY
Zip	:	11201-4848
Country	:	US
Telephone Number	:	718-874-0046
Fax Number	:	347-586-0036

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

Provider Enumeration Date	:	01/01/2008
Last Update Date	:	02/23/2017

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