Healthcare Provider Details

I. General information

NPI: 1659475267
Provider Name (Legal Business Name): LEV J PAUKMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

396 400 AVENUE X
BROOKLYN NY
11223
US

IV. Provider business mailing address

396 400 AVENUE X
BROOKLYN NY
11223
US

V. Phone/Fax

Practice location:
  • Phone: 718-376-6500
  • Fax: 718-376-5078
Mailing address:
  • Phone: 718-376-6500
  • Fax: 718-376-5078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number147367
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME147622
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: