Provider Demographics
NPI:1760671895
Name:LEXINGTON SPECIALIZED MEDICAL SERVICES, PC
Entity Type:Organization
Organization Name:LEXINGTON SPECIALIZED MEDICAL SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIBERATORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-858-2152
Mailing Address - Street 1:154 E 85TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-2168
Mailing Address - Country:US
Mailing Address - Phone:516-858-2152
Mailing Address - Fax:
Practice Address - Street 1:154 E 85TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-2168
Practice Address - Country:US
Practice Address - Phone:516-858-2152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty