Healthcare Provider Details

I. General information

NPI: 1982933446
Provider Name (Legal Business Name): OSTEOPATHY NEW YORK, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2009
Last Update Date: 05/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 E 12TH ST SUITE MD4
NEW YORK NY
10003-4632
US

IV. Provider business mailing address

44 E 12TH ST SUITE MD4
NEW YORK NY
10003-4632
US

V. Phone/Fax

Practice location:
  • Phone: 212-226-6264
  • Fax: 212-388-0677
Mailing address:
  • Phone: 212-226-6264
  • Fax: 212-388-0677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number258525
License Number StateNY

VIII. Authorized Official

Name: DR. DANIEL LOPEZ
Title or Position: PRESIDENT
Credential: D.O.
Phone: 212-226-6264