Provider Demographics
NPI:1659475267
Name:PAUKMAN, LEV J (MD)
Entity Type:Individual
Prefix:
First Name:LEV
Middle Name:J
Last Name:PAUKMAN
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 1:396 400 AVENUE X
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223
Mailing Address - Country:US
Mailing Address - Phone:718-376-6500
Mailing Address - Fax:718-376-5078
Practice Address - Street 1:396 400 AVENUE X
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223
Practice Address - Country:US
Practice Address - Phone:718-376-6500
Practice Address - Fax:718-376-5078
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2021-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME147622207RC0000X
NY147367207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00763713Medicaid
B20229Medicare UPIN
NY00763713Medicaid