Provider Demographics
NPI:1114159571
Name:DR. DAVID N LIFSCHUTZ, MD
Entity Type:Organization
Organization Name:DR. DAVID N LIFSCHUTZ, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-882-3101
Mailing Address - Street 1:PO BOX 375
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-0375
Mailing Address - Country:US
Mailing Address - Phone:516-374-2992
Mailing Address - Fax:
Practice Address - Street 1:301 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-1900
Practice Address - Country:US
Practice Address - Phone:516-374-2992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-19
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2323802084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY614N31Medicare PIN