Provider Demographics
NPI:1972678506
Name:VL MEDICAL P.C.
Entity Type:Organization
Organization Name:VL MEDICAL P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VIKTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMBERIKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FABPMR
Authorized Official - Phone:718-382-7755
Mailing Address - Street 1:1723 ELM AVE FL SUITE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5306
Mailing Address - Country:US
Mailing Address - Phone:718-382-7755
Mailing Address - Fax:718-382-7719
Practice Address - Street 1:1723 ELM AVE FL GROUND
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5306
Practice Address - Country:US
Practice Address - Phone:718-382-7755
Practice Address - Fax:718-382-7719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22-4073208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWES161Medicare ID - Type UnspecifiedMEDICARE