| Dr Mark Lowenheim, MD | |
|
200 Belle Terre Rd, Suite 400, Port Jefferson, NY 11777-1928 | |
| (631) 403-4507 | |
| (631) 509-4614 |
| Full Name | Dr Mark Lowenheim |
|---|---|
| Gender | Male |
| Speciality | Pediatrics - Pediatric Gastroenterology |
| Location | 200 Belle Terre Rd, Port Jefferson, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285676429 | NPI | - | NPPES |
| 01209796 | Medicaid | NY | |
| 21F92 | Other | NY | EMPIRE BC.BS |
| 4229601 | Other | NY | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2080P0206X | Pediatrics - Pediatric Gastroenterology | 170700 (New York) | Primary |
| Entity Name | St Charles Hospital Corp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1497765630 PECOS PAC ID: 6103733050 Enrollment ID: O20050205000015 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mark Lowenheim, MD 200 Belle Terre Rd, Suite 400, Port Jefferson, NY 11777-1928 Ph: (631) 403-4507 | Dr Mark Lowenheim, MD 200 Belle Terre Rd, Suite 400, Port Jefferson, NY 11777-1928 Ph: (631) 403-4507 |
Sana Amber Hameedi, D.O Pediatrics Medicare: Medicare Enrolled Practice Location: 200 Belle Terre Rd, Port Jefferson, NY 11777 Phone: 631-474-6000 | |
James P. Cavanagh, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 200 Belle Terre Rd, Port Jefferson, NY 11777 Phone: 631-474-6205 Fax: 631-476-5602 | |
Dr. Mary Cherian Palathra, D.O. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 200 Belle Terre Rd, Port Jefferson, NY 11777 Phone: 631-474-6205 | |
Dr. Roberta Nataloni, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 200 Belle Terre Rd, Port Jefferson, NY 11777 Phone: 631-474-6000 | |
Nancy Strong, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 200 Belle Terre Rd, Port Jefferson, NY 11777 Phone: 631-474-6000 | |
Dr. Juliette Avigdor Trope, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 200 Belle Terre Road, Port Jefferson, NY 11777 Phone: 631-474-6205 |