Active NPI
LNW Medical Office, PLLC
- Ph.D. Medical Genetics
- Huntington Station, NY
National Provider Identifier
1720107584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ph.D. Medical Genetics
- License
- 188903
- Legal business name
- LNW MEDICAL OFFICE, PLLC
- Practice address
- 33 Walt Whitman Rd Ste 100a
Huntington Station, NY 11746-3631 - Phone
- (631) 965-8166
- Fax
- (718) 732-2062
- NPI assigned
- Mar 29, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- George Mang, M.D.
- Title
- M.D.
- Phone
- (718) 886-8386
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ph.D. Medical Genetics | 170100000X | 188903 | NY | Primary |
Addresses
Primary practice location
33 Walt Whitman Rd Ste 100a
Huntington Station, NY 11746-3631
Mailing address
33 Walt Whitman Rd Ste 100a
Huntington Station, NY 11746-3631
Phone (631) 965-8166
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01663538 | Medicaid | NY |
Other names 1
- LNW MEDICAL OFFICE, PLLC
National Provider Directory
National Provider Directory- Tax ID family
- LNW Medical Office PLLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Ph.D. Medical Genetics
- Flushing, NY
- NPI 1982890356
Locations
33 Walt Whitman Rd
Ste 100A
Huntington Station, NY 11746
Phone (631) 271-3310
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Flushing, NY
- NPI 1033222831
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1720107584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 WALT WHITMAN RD STE 100A",
"city": "HUNTINGTON STATION",
"state": "NY",
"postal_code": "117463631",
"telephone_number": "631-965-8166",
"fax_number": "718-732-2062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 WALT WHITMAN RD STE 100A",
"city": "HUNTINGTON STATION",
"state": "NY",
"postal_code": "117463631",
"telephone_number": "631-965-8166",
"fax_number": "718-732-2062"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LNW MEDICAL OFFICE, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-29",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "MANG",
"authorized_official_first_name": "GEORGE",
"authorized_official_title_or_position": "M.D.",
"authorized_official_telephone_number": "718-886-8386",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "170100000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Medical Genetics, Ph.D. Medical Genetics",
"state": "NY",
"license": "188903",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01663538",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "LNW MEDICAL OFFICE, PLLC",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Huntington Station, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.