Provider Demographics
NPI:1083814339
Name:LEFKOWITZ & SCOLLAN, M.D.'S,LLC
Entity Type:Organization
Organization Name:LEFKOWITZ & SCOLLAN, M.D.'S,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:SHARON
Authorized Official - Last Name:LEFKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-235-5445
Mailing Address - Street 1:469 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06450-6027
Mailing Address - Country:US
Mailing Address - Phone:203-235-5445
Mailing Address - Fax:203-634-3985
Practice Address - Street 1:469 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06450-6027
Practice Address - Country:US
Practice Address - Phone:203-235-5445
Practice Address - Fax:203-634-3985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC02721Medicare PIN