Basic Information
| Provider Information | |||||||||
| NPI: | 1093854333 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTHTOWN OBGYN PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6161 TRANSIT RD | ||||||||
| Address2: | SUITE#5 | ||||||||
| City: | EAST AMHERST | ||||||||
| State: | NY | ||||||||
| PostalCode: | 140512606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166368284 | ||||||||
| FaxNumber: | 7166365015 | ||||||||
| Practice Location | |||||||||
| Address1: | 6161 TRANSIT RD | ||||||||
| Address2: | SUITE#5 | ||||||||
| City: | EAST AMHERST | ||||||||
| State: | NY | ||||||||
| PostalCode: | 140512606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166368284 | ||||||||
| FaxNumber: | 7166365015 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2007 | ||||||||
| LastUpdateDate: | 10/25/2011 | ||||||||
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| AuthorizedOfficialLastName: | YU | ||||||||
| AuthorizedOfficialFirstName: | TAECHIN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 7166368284 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 201585 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.