Provider Demographics
NPI:1497043673
Name:LUTHERAN MEDICAL CENTER
Entity Type:Organization
Organization Name:LUTHERAN MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR/FAMILY MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LYON
Authorized Official - Suffix:
Authorized Official - Credentials:DO,
Authorized Official - Phone:718-630-6813
Mailing Address - Street 1:9718 FORT HAMILTON PKWY
Mailing Address - Street 2:APT 3D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-8133
Mailing Address - Country:US
Mailing Address - Phone:917-226-3056
Mailing Address - Fax:
Practice Address - Street 1:150, 55TH STREET
Practice Address - Street 2:LUTHERAN MEDICAL CENTER-DEPARTMENT OF FAMILY MEDICINE
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220
Practice Address - Country:US
Practice Address - Phone:718-630-6813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital