Healthcare Provider Details
I. General information
NPI: 1255441564
Provider Name (Legal Business Name): ARNOLD LICHT MD PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/30/2006
Last Update Date: 06/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
161 ATLANTIC AVE SUITE 1
BROOKLYN NY
11201-6720
US
IV. Provider business mailing address
161 ATLANTIC AVE SUITE 1
BROOKLYN NY
11201-6720
US
V. Phone/Fax
- Phone: 718-237-2150
- Fax: 516-569-3677
- Phone: 718-237-2150
- Fax: 516-569-3677
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 173000000X |
| Taxonomy | Legal Medicine |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ARNOLD
LICHT
Title or Position: PRESIDENT/OWNER
Credential: MD
Phone: 718-237-2150