Individual
DR. MARK LOWENHEIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 BELLE TERRE RD, SUITE 400, PORT JEFFERSON, NY 11777-1928
(631) 403-4507
(631) 509-4614
Mailing address
200 BELLE TERRE RD, SUITE 400, PORT JEFFERSON, NY 11777-1928
(631) 403-4507
(631) 509-4614
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
170700
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01209796
—
NY
01
—
21F92
EMPIRE BC.BS
NY
01
—
4229601
AETNA
NY
Enumeration date
06/12/2006
Last updated
06/15/2015
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