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NPI Code Detail

MEDICARE: JONATHAN S LEIBOWITZ,MD,PC

MEDICARE: JONATHAN S LEIBOWITZ,MD,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
1207RN0300XNephrology Physician198424NY
2207R00000XInternal Medicine Physician198424NY

General Provider Information

NPI Number : 1689718629
Entity Type Code : Organization
Provider Name (Legal Business Name) : JONATHAN S LEIBOWITZ,MD,PC
Provider Business Mailing Address
First Line : 1343 55TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11219-4202
Country : US
Telephone Number : 718-972-7222
Fax Number :
Provider Business Practice Location Address
First Line : 1343 55TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11219-4202
Country : US
Telephone Number : 718-972-7222
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. JONATHAN LEIBOWITZ
Credential : MD
Telephone Number : 718-972-7222
Provider Enumeration Date : 02/15/2007
Last Update Date : 07/10/2008

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