MEDICARE: BENJAMIN C LIFSHITZ, MD, PC

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	167556	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407267008
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BENJAMIN C LIFSHITZ, MD, PC

Provider Business Mailing Address
First Line	:	1383 E 24TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-5142
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1928 BAY AVE
Second Line	:	4TH FLR
City	:	BROOKLYN
State	:	NY
Zip	:	11230-6214
Country	:	US
Telephone Number	:	718-646-8815
Fax Number	:	718-891-8123

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BENJAMIN LIFSHITZ
Credential	:
Telephone Number	:	718-646-8815

Provider Enumeration Date	:	05/16/2014
Last Update Date	:	05/16/2014

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