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Organization
PHYSICIAN AFFILIATE GROUP OF NEW YORK PC
Active
Organization
PHYSICIAN AFFILIATE GROUP OF NEW YORK PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL H. LEWENSOHN (MEDICAL CREDENTIALING)
(914) 403-8985
Entity
Organization
Contact information
Practice address
506 LENOX AVE, NEW YORK, NY 10037-1802
(212) 939-2467
Mailing address
506 LENOX AVE, NEW YORK, NY 10037-1802
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
001002
NY
Other
Enumeration date
01/29/2016
Last updated
09/15/2020
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