Organization
LV MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARISA VEKSMAN DO (MEDICAL DIRECTOR)
(718) 979-6300
Entity
Organization
Contact information
Practice address
59 LINDENWOOD RD, STATEN ISLAND, NY 10308-2737
(718) 979-6300
Mailing address
59 LINDENWOOD RD, STATEN ISLAND, NY 10308-2737
(718) 979-6300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
223381
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
223381
LISCENCE
NY
Enumeration date
10/10/2016
Last updated
10/10/2016
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