Organization Name: | MANHATTAN ENDOSCOPY CENTER LLC |
NPI Number: | 1124324181 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JORDAN FOWLER (EXECUTIVE DIRECTOR) |
Mailing Address: | 535 5th Ave 5th Fl Ny |
State: | NY US |
Postal Code: | 10017 |
Phone Number: | 2128740107 |
Fax Number: | 6463046474 |
NPI Enumeration Date: | 02/08/2011 |
NPI Last Update Date: | 07/23/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA1903X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Ambulatory Surgical |
Taxonomy Definition: |