Provider Demographics
NPI:1093330649
Name:C LEFEVRE MEDICAL PC
Entity Type:Organization
Organization Name:C LEFEVRE MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN LIAISON
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:RESNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-307-5558
Mailing Address - Street 1:333 E 49TH ST LBBY D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-1680
Mailing Address - Country:US
Mailing Address - Phone:561-307-5558
Mailing Address - Fax:
Practice Address - Street 1:16 SQUADRON BLVD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-5259
Practice Address - Country:US
Practice Address - Phone:561-307-5558
Practice Address - Fax:212-843-5743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-10
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty