Matrix Personalized Medicine LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MATRIX PERSONALIZED MEDICINE LLC

Practice address

45 Grove St
New Canaan, CT 06840-5330

Phone

(203) 920-1772

NPI assigned

Jun 9, 2022

Organization subpart

No

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

Authorized official

Name

Lawrence Leibowitz, MDNPI 1780692335

Title

MD

Phone

(203) 920-1772

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lawrence Leibowitz, M.D.

  • Family Medicine Physician
  • New Canaan, CT
  • NPI 1780692335
  NPD Authorized official

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

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654732800000",
    "number": "1194454603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 GROVE ST",
            "city": "NEW CANAAN",
            "state": "CT",
            "postal_code": "068405330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 GROVE ST",
            "city": "NEW CANAAN",
            "state": "CT",
            "postal_code": "068405330",
            "telephone_number": "203-920-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATRIX PERSONALIZED MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-09",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A",
        "authorized_official_last_name": "LEIBOWITZ",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "203-920-1772",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Mao, PHD
• George Jeffrey Marchese, LPC
• Daniel Evan Mason, MD
• Alicia Masucci, MD
• Michaela Rose Matos, DMD
• Ann Bonner McCarthy, MS CCC-SLP
• Kristin D Mehta, AGPCNP
• Holly Dale Mensching
• Alexandra Minicucci, LCSW
• Diana Mitova, LMSW

• Family Medicine Physician in New Canaan, CT
• Providers in New Canaan, CT by specialty
• Family Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.