Basic Information
| Provider Information | |||||||||
| NPI: | 1619066941 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | METALIOS | ||||||||
| FirstName: | EVA | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 451 E 14TH ST | ||||||||
| Address2: | APT. 9A | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100092802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7185792500 | ||||||||
| FaxNumber: | 7185792599 | ||||||||
| Practice Location | |||||||||
| Address1: | MMG - CHCC | ||||||||
| Address2: | 305 EAST 161ST STREET | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10451 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7185792500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 196597 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.