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Organization
LAKEVILLE COMPREHENSIVE MEDICAL INJURY CARE P.L.L.C
Active
Organization
LAKEVILLE COMPREHENSIVE MEDICAL INJURY CARE P.L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAHANSHAH ROOFEH M.D (PRESIDENT)
(516) 358-7557
Entity
Organization
Contact information
Practice address
2035 LAKEVILLE RD STE 300, NEW HYDE PARK, NY 11040-1661
(516) 492-3307
(516) 492-3299
Mailing address
2035 LAKEVILLE RD STE 300, NEW HYDE PARK, NY 11040-1661
(516) 492-3307
(516) 492-3299
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
235820
NY
208100000X
Physical Medicine & Rehabilitation Physician
Primary
248529-1
NY
208100000X
Physical Medicine & Rehabilitation Physician
A241419
NY
Other
Enumeration date
02/09/2012
Last updated
02/09/2012
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