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General NPI Number Information
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NPI Number | 1619089513
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Entity Type | Individual
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Provider Name | EDWARD LEBOVICS MD
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 11/16/2021
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Provider Practice Location Address
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Address Line | 19 BRADHURST AVE STE 2550
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City | HAWTHORNE
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State | NY
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Zip | 10532-2176
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Country | US
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Telephone | 914-493-7337
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Fax | 914-594-4317
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Provider Business Mailing Address
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Address Line | 19 BRADHURST AVE STE 2550
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City | HAWTHORNE
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State | NY
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Zip | 10532-2176
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Country | US
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Telephone | 914-493-7337
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Fax | 914-594-4317
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 153240
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License Number State | NY
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