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General NPI Number Information
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NPI Number | 1164432043
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Entity Type | Individual
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Provider Name | ILYSE SIMONE LEFKOWICZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 01/14/2020
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Provider Practice Location Address
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Address Line | 106 GRAND AVE
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-3574
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Country | US
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Telephone | 201-567-8884
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Fax | 201-567-1707
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Provider Business Mailing Address
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Address Line | 875 5TH AVE # 2B
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City | NEW YORK
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State | NY
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Zip | 10065-4952
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Country | US
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Telephone | 212-288-3200
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Fax | 212-288-3226
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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 | 237074
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License Number State | NY
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