MEDICARE: LION MEDICAL, 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
1	225400000X	Rehabilitation Practitioner	209983	NY

General Provider Information

NPI Number	:	1992102925
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LION MEDICAL, PC

Provider Business Mailing Address
First Line	:	2 BEL AIR CT
Second Line	:
City	:	MILLTOWN
State	:	NJ
Zip	:	08850-2183
Country	:	US
Telephone Number	:	917-345-8840
Fax Number	:

Provider Business Practice Location Address
First Line	:	81 ELIZABETH ST
Second Line	:	SUITE 602
City	:	NEW YORK
State	:	NY
Zip	:	10013-4729
Country	:	US
Telephone Number	:	212-219-9262
Fax Number	:	212-219-9263

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	DR. SIMON LEE
Credential	:	M.D.
Telephone Number	:	917-345-8840

Provider Enumeration Date	:	11/19/2014
Last Update Date	:	11/21/2014

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