Provider Demographics
NPI:1639286099
Name:LUTHERAN MEDICAL CENTER
Entity Type:Organization
Organization Name:LUTHERAN MEDICAL CENTER
Other - Org Name:CARIBBEAN AMERICAN FAMILY HEALTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TOYCINA
Authorized Official - Middle Name:E
Authorized Official - Last Name:AGUILH-FIGARO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-940-9425
Mailing Address - Street 1:521 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-3314
Mailing Address - Country:US
Mailing Address - Phone:516-414-2921
Mailing Address - Fax:
Practice Address - Street 1:3414 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2714
Practice Address - Country:US
Practice Address - Phone:718-940-4949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY216962261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health