Organization Name: | CHS NY MEDICAL, P.C. |
NPI Number: | 1033486568 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STUART CLARK (EXECUTIVE VP) |
Mailing Address: | 101 Barclay St 1 East New York |
State: | NY US |
Postal Code: | 100072550 |
Phone Number: | 2128154910 |
Fax Number: | |
NPI Enumeration Date: | 11/29/2011 |
NPI Last Update Date: | 02/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |