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General NPI Number Information
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NPI Number | 1841410925
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Entity Type | Individual
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Provider Name | LINCOLN MATHER CLEVELAND MD
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Gender | Male
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Dates
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Enumeration Date | 04/30/2007
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Last Update Date | 12/16/2019
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Provider Practice Location Address
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Address Line | 70 PINE STREET 26TH FLOOR AIG MEDICAL DEPT
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City | NEW YORK
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State | NY
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Zip | 10270
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Country | US
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Telephone | 212-770-5117
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Fax | 212-825-5127
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Provider Business Mailing Address
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Address Line | 175 W 73RD ST APT 10F
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City | NEW YORK
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State | NY
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Zip | 10023-2933
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Country | US
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Telephone | 212-362-6496
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Fax | 212-362-6496
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 174466
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License Number State | NY
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