Provider Demographics
NPI:1891130225
Name:LV MEDICAL ASSOCIATE, P.C.
Entity Type:Organization
Organization Name:LV MEDICAL ASSOCIATE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HEYI
Authorized Official - Middle Name:
Authorized Official - Last Name:LU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-888-0162
Mailing Address - Street 1:14210 ROOSEVELT AVE STE 22
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-6000
Mailing Address - Country:US
Mailing Address - Phone:718-888-0162
Mailing Address - Fax:
Practice Address - Street 1:14210 ROOSEVELT AVE STE 22
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-6000
Practice Address - Country:US
Practice Address - Phone:718-888-0162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYA261837208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty