Organization Active NPI

LNW Medical Office, PLLC

  • Ph.D. Medical Genetics
  • Huntington Station, NY
National Provider Identifier
1720107584
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ph.D. Medical GeneticsTaxonomy code 170100000X
License
188903 Issued in NY
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

Updated by the provider on Aug 22, 2020

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)CodeLicenseStatePrimary
Ph.D. Medical GeneticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
01663538MedicaidNY

Other names 1

  • LNW MEDICAL OFFICE, PLLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
LNW Medical Office PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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.

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.

Verify at the official NPI Registry.