Organization
LIFELINE MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OMAR GUTIERREZ (PRESIDENT)
(212) 255-2333
Entity
Organization
Contact information
Practice address
121 S OCEAN AVE, SUITE 2, FREEPORT, NY 11520-4558
(212) 255-2333
Mailing address
121 S OCEAN AVE, SUITE 2, FREEPORT, NY 11520-4558
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Enumeration date
10/20/2009
Last updated
10/20/2009
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