Provider Demographics
NPI:1649585431
Name:SCHLESSINGER-LEVI-POLATSCH-TYDINGS, MD PC
Entity Type:Organization
Organization Name:SCHLESSINGER-LEVI-POLATSCH-TYDINGS, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:TYDINGS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-931-4800
Mailing Address - Street 1:400 S OYSTER BAY RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-3500
Mailing Address - Country:US
Mailing Address - Phone:516-931-4800
Mailing Address - Fax:516-931-7241
Practice Address - Street 1:400 S OYSTER BAY RD
Practice Address - Street 2:SUITE 204
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-3500
Practice Address - Country:US
Practice Address - Phone:516-931-4800
Practice Address - Fax:516-931-7241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB16053Medicare UPIN
NYB16534Medicare UPIN