| Organization Name: | LULA MEDICAL, P.C. |
| NPI Number: | 1033368972 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ERIC ROTH (PRESIDENT) |
| Mailing Address: | 178 Ancon Ave Pelham |
| State: | NY US |
| Postal Code: | 108032005 |
| Phone Number: | 9142351489 |
| Fax Number: | 9142351489 |
| NPI Enumeration Date: | 09/16/2008 |
| NPI Last Update Date: | 09/16/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0400X |
| License Number: | 184192 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |