MEDICARE: PL MEDICAL 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	167829	NY

General Provider Information

NPI Number	:	1467493775
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PL MEDICAL PC

Provider Business Mailing Address
First Line	:	135 OCEAN PKWY
Second Line	:	SUITE 1H
City	:	BROOKLYN
State	:	NY
Zip	:	11218-2567
Country	:	US
Telephone Number	:	718-853-5560
Fax Number	:	718-853-5567

Provider Business Practice Location Address
First Line	:	135 OCEAN PKWY
Second Line	:	SUITE 1H
City	:	BROOKLYN
State	:	NY
Zip	:	11218-2567
Country	:	US
Telephone Number	:	718-853-5560
Fax Number	:	718-853-5567

Authorized Official
Title or Position	:	CEO
Name	:	DR. PAULA LEWIS
Credential	:	M.D.
Telephone Number	:	718-853-5560

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	08/22/2020

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