Individual
DR. HYLTON IVAN LIGHTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, DCH, FAAP
Contact information
Practice address
601 JARVIS AVE, FAR ROCKAWAY, NY 11691-5425
(718) 868-4808
(718) 868-2270
Mailing address
601 JARVIS AVE, FAR ROCKAWAY, NY 11691-5425
(718) 868-4808
(718) 868-2270
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
165455
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01507042
—
NY
Enumeration date
12/24/2006
Last updated
07/08/2007
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