MEDICARE: LEXINGTON SPECIALIZED SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician

General Provider Information

NPI Number	:	1265512842
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEXINGTON SPECIALIZED SERVICES, INC.

Provider Business Mailing Address
First Line	:	154 E 85TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10028-2103
Country	:	US
Telephone Number	:	516-858-2152
Fax Number	:

Provider Business Practice Location Address
First Line	:	154 E 85TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10028-2103
Country	:	US
Telephone Number	:	516-858-2152
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LISA LIBERATORE
Credential	:
Telephone Number	:	516-858-2152

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	08/22/2020

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