1669749982 NPI number — STEVEN RADOWITZ MD PRIMARY CARE

Table of content: (NPI 1669749982)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669749982 NPI number — STEVEN RADOWITZ MD PRIMARY CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STEVEN RADOWITZ MD PRIMARY CARE
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:
1669749982
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/01/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
139 W 82ND ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10024-5544
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-496-7200
Provider Business Mailing Address Fax Number:
212-874-4690

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 WEST ST
Provider Second Line Business Practice Location Address:
HEALTH CARE CENTER, 10TH 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:
10282-2102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-357-6339
Provider Business Practice Location Address Fax Number:
646-446-0375
Provider Enumeration Date:
12/01/2011

Additional Information

Authorized Official

Authorized Official Last Name:
RADOWITZ
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
Authorized Official Title or Position:
PHYSICIAN OWNER
Authorized Official Telephone Number:
917-270-5404

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  226877 , 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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