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NPI Code Detail

MEDICARE: JOHANN ERIC CASALLAS

MEDICARE: JOHANN ERIC CASALLAS
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
1246Y00000XHealth Information Specialist/Technologist

General Provider Information

NPI Number : 1902315377
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHANN ERIC CASALLAS
Provider Business Mailing Address
First Line : 307 W 38TH ST FL 6
Second Line :
City : NEW YORK
State : NY
Zip : 10018-9537
Country : US
Telephone Number : 212-695-5441
Fax Number : 212-695-4561
Provider Business Practice Location Address
First Line : 307 W 38TH ST FL 6
Second Line :
City : NEW YORK
State : NY
Zip : 10018-9537
Country : US
Telephone Number : 212-695-5441
Fax Number : 212-695-4561
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2017
Last Update Date : 07/21/2022

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Directions to “ JOHANN ERIC CASALLAS ” Practice Location

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