Organization
SL PHYSICIAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVAN LAFEMINA (BILLING MANAGER)
(631) 741-3369
Entity
Organization
Contact information
Practice address
240 W 73RD ST, NEW YORK, NY 10023-2700
(212) 362-4656
(888) 714-1889
Mailing address
240 W 73RD ST, NEW YORK, NY 10023-2700
(212) 362-4656
(888) 714-1889
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
240678
NYS MEDICAL LICENSE
NY
Enumeration date
05/24/2019
Last updated
06/24/2020
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