MEDICARE: CLUNY LEFEVRE DO

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	207Q00000X	Family Medicine Physician	205008-1	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	:	1477505147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLUNY LEFEVRE DO

Provider Business Mailing Address
First Line	:	427 FORT WASHINGTON AVE APT 1C
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10033-3522
Country	:	US
Telephone Number	:	212-740-4600
Fax Number	:	212-740-4604

Provider Business Practice Location Address
First Line	:	427 FORT WASHINGTON AVE APT 1C
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10033-3522
Country	:	US
Telephone Number	:	212-740-4600
Fax Number	:	212-740-4604

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

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	09/14/2023

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Directions to “ CLUNY LEFEVRE DO” Practice Location

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