Provider Demographics
NPI:1467493775
Name:PL MEDICAL PC
Entity Type:Organization
Organization Name:PL MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-853-5560
Mailing Address - Street 1:135 OCEAN PKWY
Mailing Address - Street 2:SUITE 1H
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-2567
Mailing Address - Country:US
Mailing Address - Phone:718-853-5560
Mailing Address - Fax:718-853-5567
Practice Address - Street 1:135 OCEAN PKWY
Practice Address - Street 2:SUITE 1H
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-2567
Practice Address - Country:US
Practice Address - Phone:718-853-5560
Practice Address - Fax:718-853-5567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY167829207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty