Provider Demographics
NPI:1942369368
Name:LEFER, GARY LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:LEE
Last Name:LEFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:300 W END AVE
Mailing Address - Street 2:SUITE 9-A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-8156
Mailing Address - Country:US
Mailing Address - Phone:212-873-3030
Mailing Address - Fax:212-523-7720
Practice Address - Street 1:300 WEST END AVE
Practice Address - Street 2:SUITE 9-A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-8156
Practice Address - Country:US
Practice Address - Phone:212-873-3030
Practice Address - Fax:212-523-7720
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0990742084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01598416Medicaid
NY663421Medicare ID - Type Unspecified
NY17719Medicare UPIN