1457741159 NPI number — NEW YORK INTERNAL MEDICINE, PC

Table of content: (NPI 1457741159)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457741159 NPI number — NEW YORK INTERNAL MEDICINE, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW YORK INTERNAL 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:
1457741159
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/02/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1752 FRANCIS LEWIS BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITESTONE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11357-3247
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-339-7858
Provider Business Mailing Address Fax Number:
814-339-6165

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1865 AMSTERDAM AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10031-1716
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-491-0100
Provider Business Practice Location Address Fax Number:
212-491-0114
Provider Enumeration Date:
02/02/2015

Additional Information

Authorized Official

Authorized Official Last Name:
MEEK
Authorized Official First Name:
REBECCA
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLING MANAGER
Authorized Official Telephone Number:
814-339-7858

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  267642-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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