Provider Demographics
NPI:1336140631
Name:CROFT, LORI B (MD)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:B
Last Name:CROFT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name Type:
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Mailing Address - Street 1:ONE GUSTAVE LEVY PLACE
Mailing Address - Street 2:1030
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:212-241-5170
Mailing Address - Fax:212-369-3269
Practice Address - Street 1:ONE GUSTAVE LEVY PLACE
Practice Address - Street 2:1030
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-241-5170
Practice Address - Fax:212-369-3269
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2009-09-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY198423207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01665741Medicaid
NYG29851Medicare UPIN
NY01665741Medicaid