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General NPI Number Information
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NPI Number | 1013902444
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Entity Type | Individual
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Provider Name | DR. MARK LEBWOHL
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Gender | Male
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Dates
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Enumeration Date | 09/12/2005
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Last Update Date | 04/12/2011
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Provider Practice Location Address
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Address Line | 5 E 98TH ST 5TH FLOOR BOX 1048
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City | NEW YORK
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State | NY
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Zip | 10029-6501
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Country | US
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Telephone | 212-241-5778
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Fax |
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Provider Business Mailing Address
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Address Line | 300 E 85TH ST APT 2505
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City | NEW YORK
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State | NY
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Zip | 10028-4500
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Country | US
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Telephone | 212-734-6762
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 141913
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License Number State | NY
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