Healthcare Provider Details

I. General information

NPI: 1407908759
Provider Name (Legal Business Name): LINCOLN MEDICAL & MENTAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11045 71ST RD
FOREST HILLS NY
11375-4960
US

IV. Provider business mailing address

11045 71ST RD
FOREST HILLS NY
11375-4960
US

V. Phone/Fax

Practice location:
  • Phone: 718-793-4293
  • Fax:
Mailing address:
  • Phone: 718-793-4293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MISS JANIS LASKY
Title or Position: SOCIAL WORK SUPERVISOR I
Credential: LCSW-R
Phone: 718-579-5657