Healthcare Provider Details
I. General information
NPI: 1689749723
Provider Name (Legal Business Name): BARRY SCOTT LOWY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/22/2006
Last Update Date: 01/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2828 S SEACREST BLVD SUIT 214
BOYNTON BEACH FL
33435-7944
US
IV. Provider business mailing address
2828 S SEACREST BLVD SUIT 214
BOYNTON BEACH FL
33435-7944
US
V. Phone/Fax
- Phone: 561-734-1888
- Fax:
- Phone: 561-734-1888
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | ME96386 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: