Healthcare Provider Details

I. General information

NPI: 1134883325
Provider Name (Legal Business Name): CPL MEDICAL P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2021
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

336 W PASSAIC ST STE 311
ROCHELLE PARK NJ
07662-3027
US

IV. Provider business mailing address

125 W 128TH ST APT 1
NEW YORK NY
10027-3021
US

V. Phone/Fax

Practice location:
  • Phone: 845-518-5515
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CLUNY LEFEVRE
Title or Position: OWNER
Credential: MD
Phone: 845-518-5515