Healthcare Provider Details

I. General information

NPI: 1235466087
Provider Name (Legal Business Name): MARTIN P LEFKOWITZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2009
Last Update Date: 11/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 BURLINGTON AVE
SUFFERN NY
10901-7426
US

IV. Provider business mailing address

15 BURLINGTON AVE
SUFFERN NY
10901-7426
US

V. Phone/Fax

Practice location:
  • Phone: 845-368-3318
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number178076-1
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: