MEDICARE: DMITRY LVOVSKY MD

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	044708	CT
2	207RP1001X	Pulmonary Disease Physician	044708	CT
3	207R00000X	Internal Medicine Physician	237730	NY
4	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	237730	NY
5	207RP1001X	Pulmonary Disease Physician	237730	NY
6	207RS0012X	Sleep Medicine (Internal Medicine) Physician	237730	NY
7	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	044708	CT
8	207RS0012X	Sleep Medicine (Internal Medicine) Physician	044708	CT

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	044708	OTHER	CT	CT STATE MEDICAL LIC
2	237730	OTHER	NY	NY STATE MED LIC

NPI Number	:	1780795005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DMITRY LVOVSKY MD

Provider Business Mailing Address
First Line	:	2451 E 2ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-6041
Country	:	US
Telephone Number	:	718-288-1090
Fax Number	:	718-708-5690

Provider Business Practice Location Address
First Line	:	1650 GRAND CONCOURSE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10457-7606
Country	:	US
Telephone Number	:	718-466-8160
Fax Number	:	718-466-8184

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	02/27/2009

1650 GRAND CONCOURSE , DEPARTMENT OF EMERGENCY MEDICINE
BRONX, NY
10457-7606

Practice Phone: 718-518-5046
Practice Fax: