| Organization Name: | LIFESTYLE MEDICAL PC |
| NPI Number: | 1538431267 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SERGEY GABINSKY (PRESIDENT) |
| Mailing Address: | 3350 Nostrand Ave Brooklyn |
| State: | NY US |
| Postal Code: | 112294004 |
| Phone Number: | 6465447198 |
| Fax Number: | 7185044036 |
| NPI Enumeration Date: | 01/26/2012 |
| NPI Last Update Date: | 01/26/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 199910-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |