Provider Demographics
NPI:1982676334
Name:LEWANDOSKI, MARC ALBERT (DO)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:ALBERT
Last Name:LEWANDOSKI
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Gender:M
Credentials:DO
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Mailing Address - Street 1:16 VAN COTT RD
Mailing Address - Street 2:SUITE 2E
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-6519
Mailing Address - Country:US
Mailing Address - Phone:631-274-0777
Mailing Address - Fax:631-274-9499
Practice Address - Street 1:16 VAN COTT RD
Practice Address - Street 2:SUITE 2E
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-6519
Practice Address - Country:US
Practice Address - Phone:631-274-0777
Practice Address - Fax:631-274-9499
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2014-08-06
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Provider Licenses
StateLicense IDTaxonomies
NY211762-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine