Provider Demographics
NPI:1760116503
Name:LINCOLN MEDICAL AND MENTAL HEALTH CENTRE
Entity Type:Organization
Organization Name:LINCOLN MEDICAL AND MENTAL HEALTH CENTRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT PGY - L1
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:IMEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-916-7624
Mailing Address - Street 1:2310 2ND AVE APT 4D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-4114
Mailing Address - Country:US
Mailing Address - Phone:917-916-7624
Mailing Address - Fax:
Practice Address - Street 1:234 E 149TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5504
Practice Address - Country:US
Practice Address - Phone:718-579-6840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty