Provider Demographics
NPI:1861406191
Name:LVOVSKY, PAUL E (DO)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:E
Last Name:LVOVSKY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2505 86TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-4414
Mailing Address - Country:US
Mailing Address - Phone:718-265-4300
Mailing Address - Fax:718-996-0965
Practice Address - Street 1:2505 86TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-4414
Practice Address - Country:US
Practice Address - Phone:718-265-4300
Practice Address - Fax:718-996-0965
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2157832085R0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2426924Medicaid
NYH93587Medicare UPIN
NY2426924Medicaid