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NPI Code Detail

MEDICARE: NEW ERA MEDICINE PLLC

MEDICARE: NEW ERA MEDICINE PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician197816NY

General Provider Information

NPI Number : 1487853503
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW ERA MEDICINE PLLC
Provider Business Mailing Address
First Line : 26 SCRIBNER AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10301-2316
Country : US
Telephone Number : 866-715-1727
Fax Number : 866-715-1727
Provider Business Practice Location Address
First Line : 1428 VICTORY BLVD
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10301-3908
Country : US
Telephone Number : 866-715-1727
Fax Number : 866-715-1727
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. RUTH ANNE REID-THORNTON
Credential : MD
Telephone Number : 866-715-1727
Provider Enumeration Date : 07/18/2007
Last Update Date : 06/22/2012

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Directions to “NEW ERA MEDICINE PLLC ” Practice Location

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