MEDICARE: LENOX HILL MEDICAL ASSOCIATES, 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	2085R0001X	Radiation Oncology Physician

General Provider Information

NPI Number	:	1952382855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LENOX HILL MEDICAL ASSOCIATES, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 9619
Second Line	:
City	:	UNIONDALE
State	:	NY
Zip	:	11555-9619
Country	:	US
Telephone Number	:	770-693-2622
Fax Number	:	770-693-6039

Provider Business Practice Location Address
First Line	:	61 E 77TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10075-1817
Country	:	US
Telephone Number	:	212-722-2130
Fax Number	:	212-722-2147

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANTHONY M BERSON
Credential	:	M.D.
Telephone Number	:	212-722-2130

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	08/09/2011

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