Provider Demographics
NPI:1417139346
Name:LLOBET MEDICAL GROUP PLLC
Entity Type:Organization
Organization Name:LLOBET MEDICAL GROUP PLLC
Other - Org Name:LLOBET MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:LLOBET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-468-2592
Mailing Address - Street 1:PO BOX 6001
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-0001
Mailing Address - Country:US
Mailing Address - Phone:347-468-2592
Mailing Address - Fax:646-626-7555
Practice Address - Street 1:42084 STATE HIGHWAY 28
Practice Address - Street 2:
Practice Address - City:MARGARETVILLE
Practice Address - State:NY
Practice Address - Zip Code:12455-2820
Practice Address - Country:US
Practice Address - Phone:845-586-3888
Practice Address - Fax:646-626-7555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242675207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty