Provider Demographics
NPI:1154484384
Name:WASSERMAN, LLOYD IAN (MD)
Entity Type:Individual
Prefix:DR
First Name:LLOYD
Middle Name:IAN
Last Name:WASSERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:462 1ST AVE
Mailing Address - Street 2:BELLEVUE MEDICAL CLINIC, ROOM 2106
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-9196
Mailing Address - Country:US
Mailing Address - Phone:212-562-1686
Mailing Address - Fax:212-562-1665
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:BELLEVUE MEDICAL CLINIC, ROOM 2106
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:212-562-1686
Practice Address - Fax:212-562-1665
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY198057207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine