Provider Demographics
NPI:1821288044
Name:LENOX HEALING MEDICAL, P.C.
Entity Type:Organization
Organization Name:LENOX HEALING MEDICAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-459-7707
Mailing Address - Street 1:10440 QUEENS BLVD STE 1L
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3658
Mailing Address - Country:US
Mailing Address - Phone:718-459-7707
Mailing Address - Fax:
Practice Address - Street 1:10440 QUEENS BLVD STE 1L
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-3658
Practice Address - Country:US
Practice Address - Phone:718-459-7707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04428AMedicare PIN