Provider Demographics
NPI:1245250679
Name:LIFSHITZ, BENJAMIN C (MD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:C
Last Name:LIFSHITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1928 BAY AVE
Mailing Address - Street 2:FLR 4
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-6214
Mailing Address - Country:US
Mailing Address - Phone:718-646-1818
Mailing Address - Fax:718-891-8123
Practice Address - Street 1:1928 BAY AVE
Practice Address - Street 2:FLR 4
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-6214
Practice Address - Country:US
Practice Address - Phone:718-646-1818
Practice Address - Fax:718-891-8123
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY167556207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
10E022Medicare ID - Type Unspecified
NYA60472Medicare UPIN