Healthcare Provider Details

I. General information

NPI: 1497983472
Provider Name (Legal Business Name): GAIL LOWENSTEIN, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2009
Last Update Date: 06/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CAROL LN
GLEN HEAD NY
11545-2916
US

IV. Provider business mailing address

1 CAROL LN
GLEN HEAD NY
11545-2916
US

V. Phone/Fax

Practice location:
  • Phone: 516-236-3204
  • Fax: 516-626-7685
Mailing address:
  • Phone: 516-236-3204
  • Fax: 516-626-7685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number143216
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number143216
License Number StateNY

VIII. Authorized Official

Name: GAIL I LOWENSTEIN
Title or Position: OWNER
Credential: M.D.
Phone: 516-236-3204