Healthcare Provider Details

I. General information

NPI: 1528202058
Provider Name (Legal Business Name): MANHATTAN TOTAL HEALTH AND GENERAL MEDICINE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2009
Last Update Date: 04/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 E 49TH ST 5TH FLOOR
NEW YORK NY
10017-1025
US

IV. Provider business mailing address

22 E 49TH ST 5TH FLOOR
NEW YORK NY
10017-1025
US

V. Phone/Fax

Practice location:
  • Phone: 212-832-9127
  • Fax: 212-832-4673
Mailing address:
  • Phone: 212-832-9127
  • Fax: 212-832-4673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. KIMBERLEY ANN JASON
Title or Position: BILLING MANAGER
Credential:
Phone: 212-906-9062