Provider Demographics
NPI:1336197433
Name:BRIGHTMAN, LORI A (MD)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:BRIGHTMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 EAST 34TH STREET
Mailing Address - Street 2:11TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:212-686-7306
Mailing Address - Fax:212-686-7305
Practice Address - Street 1:317 EAST 34TH STREET
Practice Address - Street 2:11TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-686-7306
Practice Address - Fax:212-686-7305
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA217433207N00000X
NY243811-1207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology