MEDICARE: LENOX HILL FACULTY MEDICAL AFFILIATES UNIVERSITY FACULTY PRAC

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1619713716
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LENOX HILL FACULTY MEDICAL AFFILIATES UNIVERSITY FACULTY PRAC

Provider Business Mailing Address
First Line	:	100 E 77TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10075-1850
Country	:	US
Telephone Number	:	212-434-2000
Fax Number	:	212-434-2002

Provider Business Practice Location Address
First Line	:	100 E 77TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10075-1850
Country	:	US
Telephone Number	:	212-434-2000
Fax Number	:	212-434-2002

Authorized Official
Title or Position	:	DIRECTOR
Name	:	SHARLENE BRONSTORPH
Credential	:
Telephone Number	:	516-850-3999

Provider Enumeration Date	:	07/08/2024
Last Update Date	:	12/17/2025

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