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General NPI Number Information
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NPI Number | 1467812834
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Entity Type | Organization
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Legal Business Name | DR MICHAEL E LESSIN
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Dates
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Enumeration Date | 02/29/2016
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Last Update Date | 02/29/2016
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Provider Practice Location Address
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Address Line | 27005 76TH AVE DEPARTMENT OF DENTAL MEDICINE
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-1402
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Country | US
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Telephone | 718-470-7130
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Fax | 718-470-5423
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Provider Business Mailing Address
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Address Line | 27005 76TH AVE DEPARTMENT OF DENTAL MEDICINE
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-1402
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Country | US
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Telephone | 718-470-7130
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Fax | 718-470-5423
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Authorized Official
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Title or Position | SECRETARY
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Name | MRS. MARILYN CARABAJO
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Credential |
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Telephone | 718-470-7130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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License Number | 053824-1
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License Number State | NY
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