Provider Demographics
NPI:1407908759
Name:LINCOLN MEDICAL & MENTAL HEALTH CENTER
Entity Type:Organization
Organization Name:LINCOLN MEDICAL & MENTAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORK SUPERVISOR I
Authorized Official - Prefix:MISS
Authorized Official - First Name:JANIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LASKY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:718-579-5657
Mailing Address - Street 1:11045 71ST RD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4960
Mailing Address - Country:US
Mailing Address - Phone:718-793-4293
Mailing Address - Fax:
Practice Address - Street 1:11045 71ST RD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4960
Practice Address - Country:US
Practice Address - Phone:718-793-4293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR0168261OtherSOCIAL WORK