Provider Demographics
NPI:1568465714
Name:BAREK, LOWELL B (MD)
Entity Type:Individual
Prefix:
First Name:LOWELL
Middle Name:B
Last Name:BAREK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 7TH ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-5774
Mailing Address - Country:US
Mailing Address - Phone:516-747-0161
Mailing Address - Fax:516-747-0166
Practice Address - Street 1:224 7TH ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-5774
Practice Address - Country:US
Practice Address - Phone:516-747-0161
Practice Address - Fax:516-747-0166
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1276032085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00407323Medicaid
NY05211QOtherGHI MEDICARE
NYC08162Medicare UPIN
NY307921Medicare PIN