MEDICARE: GENADY LILEVMAN MEDICAL PLLC

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

General Provider Information

NPI Number	:	1619824570
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENADY LILEVMAN MEDICAL PLLC

Provider Business Mailing Address
First Line	:	3080 BRIGHTON 13TH ST STE 101A
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-5608
Country	:	US
Telephone Number	:	718-200-0255
Fax Number	:

Provider Business Practice Location Address
First Line	:	3080 BRIGHTON 13TH ST STE 101A
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-5608
Country	:	US
Telephone Number	:	718-200-0255
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. GENADY LILEVMAN
Credential	:	MD
Telephone Number	:	718-200-0255

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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