Organization
LENOX OTOLARYNGOLOGY HEAD & NECK SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHELE L CUSACK (SENIOR VICE PRESIDENT & CFO)
(516) 321-6058
Entity
Organization
Contact information
Practice address
366 5TH AVE RM 709, NEW YORK, NY 10001-2211
(212) 629-3223
(212) 629-3466
Mailing address
186 E 76TH ST, 2ND FLOOR, NEW YORK, NY 10021-2844
(212) 434-2323
(212) 434-6885
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
207Y00000X
Otolaryngology Physician
—
—
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
—
—
Other
Enumeration date
06/28/2007
Last updated
11/03/2020
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