Provider Demographics
NPI:1992823348
Name:LOVINA MEDICAL PC
Entity Type:Organization
Organization Name:LOVINA MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:UMEZE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-597-8383
Mailing Address - Street 1:1423 GLOVER STREET
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-4919
Mailing Address - Country:US
Mailing Address - Phone:718-597-8383
Mailing Address - Fax:718-892-0234
Practice Address - Street 1:1423 GLOVER STREET
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-4919
Practice Address - Country:US
Practice Address - Phone:718-597-8383
Practice Address - Fax:718-892-0234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty