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Organization
LAKE SUCCESS HEALTH MEDICAL WELLNESS PC
Active
Organization
LAKE SUCCESS HEALTH MEDICAL WELLNESS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY ROSEN CFO (CFO)
(914) 860-5578
Entity
Organization
Contact information
Practice address
2001 MARCUS AVE STE W95, NEW HYDE PARK, NY 11042-2052
(917) 524-7246
Mailing address
295 MADISON AVE RM 407, NEW YORK, NY 10017-6438
(914) 960-5578
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
09/19/2023
Last updated
09/20/2023
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