Provider Demographics
NPI:1891159240
Name:LM MEDICAL PLLC
Entity Type:Organization
Organization Name:LM MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DERMATOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RABACH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-687-5188
Mailing Address - Street 1:33 5TH AVE
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4377
Mailing Address - Country:US
Mailing Address - Phone:212-777-2272
Mailing Address - Fax:
Practice Address - Street 1:33 5TH AVE
Practice Address - Street 2:SUITE 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4377
Practice Address - Country:US
Practice Address - Phone:212-777-2272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249977207N00000X
NY277117207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Multi-Specialty