Organization
LAMD MEDICAL GROUP AND MULTISPECIALTY CORP
Active
Other names
LAMD MEDICAL GROUP AND MULTI SPECIALTY
Organization subpart
No
Provider details
NPI number
Authorized official
LOREN A. MARTINEZ PA (GEN. OPERATIONAL MANAGER)
(718) 639-3603
Entity
Organization
Contact information
Practice address
6506 ROOSEVELT AVE, WOODSIDE, NY 11377-2928
(718) 639-3603
(718) 639-3605
Mailing address
6506 ROOSEVELT AVE, WOODSIDE, NY 11377-2928
(718) 639-3603
(718) 639-3605
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
214048
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05593980
—
NY
01
—
33D1043979
CLIA
NY
Enumeration date
12/22/2015
Last updated
09/11/2025
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