# THE LAKE MEDICAL SERVICES, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538575857
- **Authorized official:** DR. FREDDY DESORMEAUX M.D. (M.D.)
- **Authorized official phone:** (914) 509-5836

## Contact information

- **Practice address:** 171 LAKE RD, SUITE 1, HUNTINGTON, NY 11743-3947
- **Practice address phone:** (914) 509-5836
- **Practice address fax:** (914) 357-2489
- **Mailing address:** 171 LAKE RD, SUITE 1, HUNTINGTON, NY 11743-3947
- **Mailing address phone:** (914) 509-5836
- **Mailing address fax:** (914) 357-2489

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 250020 | NY | Yes |

## Other

- **Enumeration date:** 07/08/2014
- **Last updated:** 09/24/2014