Organization
JAY S LEBOW DPM PA
Active
Other names
LEBOW PODIATRY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY S. LEBOW DPM (PRESIDENT)
(410) 332-1414
Entity
Organization
Contact information
Practice address
1626 E FORT AVE, BALTIMORE, MD 21230-5245
(410) 332-1414
(410) 332-1423
Mailing address
1626 E FORT AVE, BALTIMORE, MD 21230-5245
(410) 332-1414
(410) 332-1423
Taxonomy
Speciality
Code
Description
License number
State
213ES0000X
Sports Medicine Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
480002770
MEDICARE RAILROAD
MD
05
—
548128700
—
MD
Enumeration date
07/06/2006
Last updated
07/21/2010
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