Healthcare Provider Details

I. General information

NPI: 1386245702
Provider Name (Legal Business Name): DIAL DOC NOW MEDICAL GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2020
Last Update Date: 05/18/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 RIVERSIDE BLVD APT 7I
NEW YORK NY
10069-0908
US

IV. Provider business mailing address

200 RIVERSIDE BLVD APT 7I
NEW YORK NY
10069-0908
US

V. Phone/Fax

Practice location:
  • Phone: 917-842-0649
  • Fax:
Mailing address:
  • Phone: 917-842-0649
  • Fax: 913-490-1906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KRYSTAL MCKENNA
Title or Position: DIRECTOR
Credential:
Phone: 844-362-3425