Provider Demographics
NPI:1558313957
Name:GILBERT LEDERMAN MD PC
Entity Type:Organization
Organization Name:GILBERT LEDERMAN MD PC
Other - Org Name:RADIOSURGERY NEW YORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-246-4237
Mailing Address - Street 1:PO BOX 11649
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07101-4649
Mailing Address - Country:US
Mailing Address - Phone:732-307-7062
Mailing Address - Fax:732-387-2629
Practice Address - Street 1:1384 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-6108
Practice Address - Country:US
Practice Address - Phone:212-246-4237
Practice Address - Fax:212-813-3456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW6L741Medicare PIN