- Practice location
- 885 Park Ave, Suite 105, New York, NY 10075-0325
- Phone
- 212-535-3313
- Fax
- 212-734-3192
- Last updated
- March 30, 2011
105 East 78 Street Medical is a healthcare organization based in New York, NY. 105 East 78 Street Medical practices in New York, NY. The NPI Number for 105 East 78 Street Medical is 1578852588 and holds a License No. 60112817 (NY). The current practice location address for 105 East 78 Street Medical is 885 Park Ave, Suite 105, New York, NY 10075-0325 and can be reached out via phone at 212-535-3313 and via fax at 212-734-3192.
Provider Profile Details
- NPI Number
- 1578852588
- Provider Name
- 105 East 78 Street Medical
- Provider Entity Type
- Organization
- Address
- 885 Park Ave, Suite 105, New York, NY 10075-0325
- Phone Number
- 212-535-3313
- Fax Number
- 212-734-3192
- Primary Taxonomy
- Specialist · 174400000X
- Organization Subpart
- No
- Authorized Official
- Dr. Everett Lautin, MD · President · 212-535-3313
- Provider Enumeration Date
- March 30, 2011
- Last Update Date
- March 30, 2011
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 885 Park Ave
Suite 105
New York, NY 10075-0325 - City
- New York
- State
- New York
- Zip
- 10075-0325
- Phone Number
- 212-535-3313
- Fax Number
- 212-734-3192
Provider Business Mailing Address Details
- Address
- 885 Park Ave
Suite 105
New York, NY 10075-0325 - City
- New York
- State
- NY
- Zip
- 10075-0325
- Phone Number
- 212-535-3313
- Fax Number
- 212-734-3192
License Information
- License Number
- 60112817
- License State
- NY
- Taxonomy
- Specialist · 174400000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of 105 East 78 Street Medical?
The NPI number of 105 East 78 Street Medical is 1578852588. It was assigned on March 30, 2011 and is currently active in the NPPES registry.
What is the specialty of 105 East 78 Street Medical?
105 East 78 Street Medical is registered under the primary taxonomy Specialist (code 174400000X), licensed in NY under license number 60112817.
Where does 105 East 78 Street Medical practice?
The practice location is 885 Park Ave, Suite 105, New York, NY 10075-0325. The office can be reached at 212-535-3313 (phone) or 212-734-3192 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1578852588 directly on the NPPES registry website.