Provider Demographics
NPI:1770066821
Name:LENNOX MEDICAL GROUP PROFESSIONAL ASSOCIATION
Entity type:Organization
Organization Name:LENNOX MEDICAL GROUP PROFESSIONAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ISRAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-925-2974
Mailing Address - Street 1:1600 SAINT GEORGES AVE STE 111
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-2713
Mailing Address - Country:US
Mailing Address - Phone:973-972-6635
Mailing Address - Fax:
Practice Address - Street 1:1600 SAINT GEORGES AVE STE 111
Practice Address - Street 2:
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-2713
Practice Address - Country:US
Practice Address - Phone:973-972-6635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-13
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty