Provider Demographics
NPI:1083677272
Name:LUMERMAN, JEFFREY H (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:H
Last Name:LUMERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 FRANKLIN AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-5795
Mailing Address - Country:US
Mailing Address - Phone:516-742-3200
Mailing Address - Fax:516-746-5847
Practice Address - Street 1:601 FRANKLIN AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-5795
Practice Address - Country:US
Practice Address - Phone:516-742-3200
Practice Address - Fax:516-746-5847
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199012208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G89230Medicare UPIN