Organization Name: | PARK 34 MEDICAL ASSOCIATES PC |
NPI Number: | 1457778284 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ALEXANDER GARGER (PRESIDENT) |
Mailing Address: | 15 Park Ave Suite 1s New York |
State: | NY US |
Postal Code: | 100164348 |
Phone Number: | 2123908260 |
Fax Number: | |
NPI Enumeration Date: | 03/18/2014 |
NPI Last Update Date: | 05/19/2014 |
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: |