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General NPI Number Information
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NPI Number | 1992102925
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Entity Type | Organization
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Legal Business Name | LION MEDICAL, PC
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Dates
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Enumeration Date | 11/19/2014
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Last Update Date | 11/21/2014
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Provider Practice Location Address
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Address Line | 81 ELIZABETH ST SUITE 602
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City | NEW YORK
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State | NY
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Zip | 10013-4729
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Country | US
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Telephone | 212-219-9262
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Fax | 212-219-9263
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Provider Business Mailing Address
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Address Line | 2 BEL AIR CT
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City | MILLTOWN
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State | NJ
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Zip | 08850-2183
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Country | US
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Telephone | 917-345-8840
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | DR. SIMON LEE
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Credential | M.D.
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Telephone | 917-345-8840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number | 209983
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License Number State | NY
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