Individual
DR. MITCHELL R LOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
410 LAKEVILLE RD, SUITE 209, LAKE SUCCESS, NY 11042-1101
(516) 488-5050
(516) 326-6252
Mailing address
488 GREAT NECK RD STE 300, GREAT NECK, NY 11021-4308
(516) 482-6747
(516) 482-4851
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
199280
NY
207RG0100X
Gastroenterology Physician
Primary
199280
NY
Other
Enumeration date
10/03/2005
Last updated
08/14/2023
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