Provider Demographics
NPI:1831133131
Name:HAIMOFF, LEV (DO)
Entity Type:Individual
Prefix:DR
First Name:LEV
Middle Name:
Last Name:HAIMOFF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 W 36TH ST RM 4W
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-7658
Mailing Address - Country:US
Mailing Address - Phone:212-686-5800
Mailing Address - Fax:855-428-5426
Practice Address - Street 1:35 W 36TH ST RM 4W
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-7658
Practice Address - Country:US
Practice Address - Phone:212-686-5800
Practice Address - Fax:855-428-5426
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233707207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY163SN1Medicare ID - Type Unspecified
NYI23831Medicare UPIN