# LENOX OTOLARYNGOLOGY HEAD & NECK SURGERY PC

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

## Provider details

- **NPI number:** 1689871238
- **Authorized official:** MR. MICHELE L CUSACK (SENIOR VICE PRESIDENT & CFO)
- **Authorized official phone:** (516) 321-6058

## Contact information

- **Practice address:** 366 5TH AVE RM 709, NEW YORK, NY 10001-2211
- **Practice address phone:** (212) 629-3223
- **Practice address fax:** (212) 629-3466
- **Mailing address:** 186 E 76TH ST, 2ND FLOOR, NEW YORK, NY 10021-2844
- **Mailing address phone:** (212) 434-2323
- **Mailing address fax:** (212) 434-6885

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | Yes |
| 207Y00000X | Otolaryngology Physician | — | NULL | — |
| 207Y00000X | Otolaryngology Physician | — | — | — |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | NULL | — |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | — | — |

## Other

- **Enumeration date:** 06/28/2007
- **Last updated:** 11/03/2020