Provider Demographics
NPI:1841410925
Name:CLEVELAND, LINCOLN MATHER (MD)
Entity Type:Individual
Prefix:DR
First Name:LINCOLN
Middle Name:MATHER
Last Name:CLEVELAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:175 W 73RD ST APT 10F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-2933
Mailing Address - Country:US
Mailing Address - Phone:212-362-6496
Mailing Address - Fax:212-362-6496
Practice Address - Street 1:70 PINE STREET
Practice Address - Street 2:26TH FLOOR AIG MEDICAL DEPT
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10270
Practice Address - Country:US
Practice Address - Phone:212-770-5117
Practice Address - Fax:212-825-5127
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2019-12-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY174466207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF22282Medicare UPIN
NY61H281Medicare ID - Type Unspecified