MEDICARE: NYMA

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
1	282N00000X	General Acute Care Hospital	10429	NY

General Provider Information

NPI Number	:	1922210475
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NYMA

Provider Business Mailing Address
First Line	:	2120 CRUGER AVE APT 5G
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462-2336
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2120 CRUGER AVE APT 5G
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462-2336
Country	:	US
Telephone Number	:	718-792-9683
Fax Number	:

Authorized Official
Title or Position	:	PA
Name	:	MRS. GALINA MAKINA
Credential	:	BS
Telephone Number	:	718-519-2073

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	08/22/2020

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Directions to “NYMA ” Practice Location

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