1528202058 NPI number — MANHATTAN TOTAL HEALTH AND GENERAL MEDICINE, PC

Table of content: (NPI 1528202058)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528202058 NPI number — MANHATTAN TOTAL HEALTH AND GENERAL MEDICINE, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MANHATTAN TOTAL HEALTH AND GENERAL MEDICINE, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528202058
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/29/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22 E 49TH ST
Provider Second Line Business Mailing Address:
5TH FLOOR
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10017-1025
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-832-9127
Provider Business Mailing Address Fax Number:
212-832-4673

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
22 E 49TH ST
Provider Second Line Business Practice Location Address:
5TH FLOOR
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10017-1025
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-832-9127
Provider Business Practice Location Address Fax Number:
212-832-4673
Provider Enumeration Date:
04/28/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
JASON
Authorized Official First Name:
KIMBERLEY
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
BILLING MANAGER
Authorized Official Telephone Number:
212-906-9062

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 171100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)