Healthcare Provider Details

I. General information

NPI: 1427610914
Provider Name (Legal Business Name): LINCOLN MEDICAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2019
Last Update Date: 07/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 E 149TH ST
BRONX NY
10451-5504
US

IV. Provider business mailing address

2340 7TH AVE APT 38
NEW YORK NY
10030-2307
US

V. Phone/Fax

Practice location:
  • Phone: 718-579-5030
  • Fax:
Mailing address:
  • Phone: 718-749-8803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MAGDA MENDEZ
Title or Position: PROGRAM DIRECTOR
Credential: MD
Phone: 718-579-5030