Provider Demographics
NPI:1164270450
Name:SXP PRACTICE LLC
Entity type:Organization
Organization Name:SXP PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:FLAVIANA
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-467-9809
Mailing Address - Street 1:307 EAST SHORE ROAD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023
Mailing Address - Country:US
Mailing Address - Phone:516-467-9809
Mailing Address - Fax:
Practice Address - Street 1:307 EAST SHORE ROAD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023
Practice Address - Country:US
Practice Address - Phone:516-467-9809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SXP PRACTICE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty