Provider Demographics
NPI:1811009277
Name:LEXINGTON NEUROLOGY ASSOCIATES PC
Entity Type:Organization
Organization Name:LEXINGTON NEUROLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEXTER
Authorized Official - Middle Name:Y
Authorized Official - Last Name:SUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:212-717-8282
Mailing Address - Street 1:943 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5107
Mailing Address - Country:US
Mailing Address - Phone:212-717-8282
Mailing Address - Fax:212-717-9643
Practice Address - Street 1:943 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5107
Practice Address - Country:US
Practice Address - Phone:212-717-8282
Practice Address - Fax:212-717-9643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY204712174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY92Z011Medicare ID - Type Unspecified
NYG74165Medicare UPIN