MEDICARE: JEFFREY HOWARD LITWIN

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1578545695
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEFFREY HOWARD LITWIN

Provider Business Mailing Address
First Line	:	20507 HILLSIDE AVE
Second Line	:	SUITE 18
City	:	HOLLIS
State	:	NY
Zip	:	11423-2220
Country	:	US
Telephone Number	:	718-464-9605
Fax Number	:	718-217-5867

Provider Business Practice Location Address
First Line	:	20507 HILLSIDE AVE
Second Line	:	SUITE 18
City	:	HOLLIS
State	:	NY
Zip	:	11423-2220
Country	:	US
Telephone Number	:	718-464-9605
Fax Number	:	718-217-5867

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JEFFREY HOWARD LITWIN
Credential	:	D.P.M.
Telephone Number	:	718-464-9605

Provider Enumeration Date	:	11/15/2005
Last Update Date	:	04/03/2013

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