Healthcare Provider Details

I. General information

NPI: 1043445729
Provider Name (Legal Business Name): LIONEL AND MARIE EDITH F LEFEVRE PHYSICIANS P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2009
Last Update Date: 05/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 CLARENDON RD
BROOKLYN NY
11226-6415
US

IV. Provider business mailing address

3101 CLARENDON RD
BROOKLYN NY
11226-6415
US

V. Phone/Fax

Practice location:
  • Phone: 718-462-6611
  • Fax: 718-462-4944
Mailing address:
  • Phone: 718-462-6611
  • Fax: 718-462-4944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number155114
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number151536
License Number StateNY

VIII. Authorized Official

Name: LIONEL LEFEVRE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 718-462-6611