Organization
LAKEVILLE COMPREHENSIVE MEDICAL INJURY CARE P.L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAHANSHAH ROOFEH M.D (PRESIDENT)
(516) 358-7557
Entity
Organization
Contact information
Practice address
2035 LAKEVILLE RD STE 300, NEW HYDE PARK, NY 11040-1661
(516) 492-3307
(516) 492-3299
Mailing address
2035 LAKEVILLE RD STE 300, NEW HYDE PARK, NY 11040-1661
(516) 492-3307
(516) 492-3299
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
235820
NY
208100000X
Physical Medicine & Rehabilitation Physician
Primary
248529-1
NY
208100000X
Physical Medicine & Rehabilitation Physician
A241419
NY
Other
Enumeration date
02/09/2012
Last updated
02/09/2012
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