Healthcare Provider Details

I. General information

NPI: 1487823340
Provider Name (Legal Business Name): LIONEL G. HAUSMAN, D.P.M.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2008
Last Update Date: 01/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 E 18TH ST
NEW YORK NY
10003-2409
US

IV. Provider business mailing address

157 E 18TH ST
NEW YORK NY
10003-2409
US

V. Phone/Fax

Practice location:
  • Phone: 212-532-2220
  • Fax: 212-213-5735
Mailing address:
  • Phone: 212-532-2220
  • Fax: 212-213-5735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberN004745-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberN004745-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberN004745-1
License Number StateNY

VIII. Authorized Official

Name: DR. LIONEL G. HAUSMAN
Title or Position: OWNER
Credential: D.P.M.
Phone: 212-532-2220