MEDICARE: DR. MIRIAM LEFKOWITZ MD, PHD

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	207R00000X	Internal Medicine Physician	MA71261	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MA71261	OTHER		LICENSE
2	200440506	OTHER		TAX ID

General Provider Information

NPI Number	:	1336223080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MIRIAM LEFKOWITZ MD, PHD

Provider Business Mailing Address
First Line	:	223 LINCOLN AVE
Second Line	:
City	:	HIGHLAND PARK
State	:	NJ
Zip	:	08904-1826
Country	:	US
Telephone Number	:	732-821-5151
Fax Number	:	732-297-1616

Provider Business Practice Location Address
First Line	:	2204 US HIGHWAY 130 STE C-3
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-4805
Country	:	US
Telephone Number	:	732-821-5151
Fax Number	:	732-297-1616

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	03/07/2023

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