Healthcare Provider Details

I. General information

NPI: 1265290969
Provider Name (Legal Business Name): UL PEDIATRIC ENDOCRINOLOGY OFFICE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2024
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17007 HILLSIDE AVE FL 1
JAMAICA NY
11432-4546
US

IV. Provider business mailing address

59 MASPETH AVE APT 4B
BROOKLYN NY
11211-2543
US

V. Phone/Fax

Practice location:
  • Phone: 646-267-9584
  • Fax: 718-298-5802
Mailing address:
  • Phone: 718-489-2224
  • Fax: 718-298-5802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080B0002X
TaxonomyPediatric Obesity Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: UGEN LHAMU
Title or Position: PRESIDENT
Credential: MD
Phone: 718-489-2224