Basic Information
Provider Information
NPI: 1760569461
EntityType: 2
ReplacementNPI:  
OrganizationName: LEFFERTS MEDICAL ASSOCIATES PC
LastName:  
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Credential:  
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Mailing Information
Address1: 26619 UNION TPKE
Address2:  
City: NEW HYDE PARK
State: NY
PostalCode: 110401426
CountryCode: US
TelephoneNumber: 7183470434
FaxNumber: 7183470517
Practice Location
Address1: 26619 UNION TPKE
Address2:  
City: NEW HYDE PARK
State: NY
PostalCode: 110401426
CountryCode: US
TelephoneNumber: 7183470434
FaxNumber: 7183470517
Other Information
ProviderEnumerationDate: 11/01/2006
LastUpdateDate: 04/17/2008
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: CHHABRA
AuthorizedOfficialFirstName: INDERPAL
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: DIRETCTOR
AuthorizedOfficialTelephone: 7183470434
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X220535NYY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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