Lake Success Health Medical Wellness PC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

LAKE SUCCESS HEALTH MEDICAL WELLNESS PC

Practice address

2001 Marcus Ave Ste W95
New Hyde Park, NY 11042-2052

Phone

(917) 524-7246

NPI assigned

Sep 19, 2023

Last updated

Sep 20, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jeffrey Rosen, CFO

Title

Cfo

Phone

(914) 860-5578

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1695081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1083492128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 MADISON AVE RM 407",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176438",
            "telephone_number": "914-960-5578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 MARCUS AVE STE W95",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110422052",
            "telephone_number": "917-524-7246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "295 Madison Ave Rm 407",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100176438",
            "country_code": "US",
            "telephone_number": "917-524-7246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LAKE SUCCESS HEALTH MEDICAL WELLNESS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-19",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "ROSEN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "914-860-5578",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seema Ladhani, RN
• Keryann Ladouceur
• Stacey Ladusch, NP-
• Kin Wai Lai, MD
• Wilson Lai
• Lake Success Medical Associates
• Lake Success Neurological Surgery PC (Intra-Operative Monitoring Associates)
• Lake Success Ophthalmic Associates PC
• Lake Success Periodontics and Implants P.C.
• Lake Success Physical Therapy P.C.

• Pain Medicine (Anesthesiology) Physician in New Hyde Park, NY
• Providers in New Hyde Park, NY by specialty
• Pain Medicine (Anesthesiology) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.