# MAIMONIDES MEDICAL CENTER - MMC GASTROENTEROLOGY FPP

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

## Provider details

- **NPI number:** 1932216660
- **Authorized official:** EDGAR LICHSTEIN MD (DEPARTMENT CHAIR)
- **Authorized official phone:** (718) 283-8773

## Contact information

- **Practice address:** 4802 10TH AVE, BROOKLYN, NY 11219-2916
- **Practice address phone:** (718) 283-8773
- **Mailing address:** GPO BOX 27641, NEW YORK, NY 10087-7641

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | — | NULL | Yes |
| 207RG0100X | Gastroenterology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/25/2006
- **Last updated:** 02/13/2013