Basic Information
| Provider Information | |||||||||
| NPI: | 1457741159 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEW YORK INTERNAL MEDICINE, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1752 FRANCIS LEWIS BLVD | ||||||||
| Address2: | |||||||||
| City: | WHITESTONE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113573247 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8143397858 | ||||||||
| FaxNumber: | 8143396165 | ||||||||
| Practice Location | |||||||||
| Address1: | 1865 AMSTERDAM AVE | ||||||||
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| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100311716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2124910100 | ||||||||
| FaxNumber: | 2124910114 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2015 | ||||||||
| LastUpdateDate: | 02/02/2015 | ||||||||
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| AuthorizedOfficialLastName: | MEEK | ||||||||
| AuthorizedOfficialFirstName: | REBECCA | ||||||||
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| AuthorizedOfficialTitleorPosition: | BILLING MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 8143397858 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | NEW YORK INTERNAL MEDICINE, PC | ||||||||
| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 267642-1 | NY | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.