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Organization
MAIMONIDES MEDICAL CENTER MAIMONIDES PRIMARY CARE FPP
Active
Organization
MAIMONIDES MEDICAL CENTER MAIMONIDES PRIMARY CARE FPP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDGAR LICHSTEIN M.D. (CHAIRMAN)
(781) 283-7732
Entity
Organization
Contact information
Practice address
1250 57TH ST, BROOKLYN, NY 11219-4537
(718) 283-7732
Mailing address
PO BOX 27358, NEW YORK, NY 10087-7358
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01746785
—
NY
Enumeration date
05/12/2006
Last updated
02/13/2013
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