Healthcare Provider Details

I. General information

NPI: 1487651410
Provider Name (Legal Business Name): JAMES DAVID LAX M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2005
Last Update Date: 10/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 E 72ND ST GROUND FLOOR
NEW YORK NY
10021-4364
US

IV. Provider business mailing address

160 E 72ND ST GROUND FLOOR
NEW YORK NY
10021-4364
US

V. Phone/Fax

Practice location:
  • Phone: 212-988-5740
  • Fax: 212-988-0462
Mailing address:
  • Phone: 212-988-5740
  • Fax: 212-988-0462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number152612
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: