Healthcare Provider Details

I. General information

NPI: 1245338573
Provider Name (Legal Business Name): NYE MEDICAL SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 03/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 PELHAM PKWY N
BRONX NY
10469-5411
US

IV. Provider business mailing address

1101 PELHAM PKWY N
BRONX NY
10469-5411
US

V. Phone/Fax

Practice location:
  • Phone: 718-515-3500
  • Fax: 718-405-3806
Mailing address:
  • Phone: 718-515-3500
  • Fax: 718-405-3806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: JEROME H LEVY
Title or Position: SURGEON DIRECTOR
Credential: MD
Phone: 718-519-1000