MEDICARE: DR. JAMES R. LUNDY JR. D.O.

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	207P00000X	Emergency Medicine Physician	1727	WV
2	207P00000X	Emergency Medicine Physician	0102201110	VA
3	207P00000X	Emergency Medicine Physician	25MB07371800	NJ

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	:	1467451757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES R. LUNDY JR. D.O.

Provider Business Mailing Address
First Line	:	250 W 90TH ST
Second Line	:	APT. 10F
City	:	NEW YORK
State	:	NY
Zip	:	10024-1100
Country	:	US
Telephone Number	:	347-229-3727
Fax Number	:

Provider Business Practice Location Address
First Line	:	250 W 90TH ST
Second Line	:	APT. 10F
City	:	NEW YORK
State	:	NY
Zip	:	10024-1100
Country	:	US
Telephone Number	:	347-229-3727
Fax Number	:

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

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	04/06/2020

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Directions to “ DR. JAMES R. LUNDY JR. D.O.” Practice Location

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