Healthcare Provider Details

I. General information

NPI: 1376543959
Provider Name (Legal Business Name): JOSEPH LEBOWICZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 11/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 EAST 14TH ST STE 501
BROOKLYN NY
11229
US

IV. Provider business mailing address

1660 EAST 14TH ST STE 501
BROOKLYN NY
11229
US

V. Phone/Fax

Practice location:
  • Phone: 718-382-8500
  • Fax: 718-382-4648
Mailing address:
  • Phone: 718-382-8500
  • Fax: 718-382-4648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number129436
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: