# JAY S LEBOW DPM PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LEBOW PODIATRY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609808443
- **Authorized official:** DR. JAY S. LEBOW DPM (PRESIDENT)
- **Authorized official phone:** (410) 332-1414

## Contact information

- **Practice address:** 1626 E FORT AVE, BALTIMORE, MD 21230-5245
- **Practice address phone:** (410) 332-1414
- **Practice address fax:** (410) 332-1423
- **Mailing address:** 1626 E FORT AVE, BALTIMORE, MD 21230-5245
- **Mailing address phone:** (410) 332-1414
- **Mailing address fax:** (410) 332-1423

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0000X | Sports Medicine Podiatrist | — | NULL | Yes |
| 213ES0000X | Sports Medicine Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 07/06/2006
- **Last updated:** 07/21/2010