Provider Demographics
NPI:1710968045
Name:LEMENTOWSKI & ASSOCIATES SURGERY LLC
Entity Type:Organization
Organization Name:LEMENTOWSKI & ASSOCIATES SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMENTOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-684-7170
Mailing Address - Street 1:2 EASTGATE AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MONESSEN
Mailing Address - State:PA
Mailing Address - Zip Code:15062-1393
Mailing Address - Country:US
Mailing Address - Phone:724-684-7170
Mailing Address - Fax:724-684-7172
Practice Address - Street 1:2 EASTGATE AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:MONESSEN
Practice Address - State:PA
Practice Address - Zip Code:15062-1393
Practice Address - Country:US
Practice Address - Phone:724-684-7170
Practice Address - Fax:724-684-7172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-14
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038244L207Q00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006293510001Medicaid
X89508Medicare UPIN
069246Medicare ID - Type Unspecified
D71173Medicare UPIN