Healthcare Provider Details

I. General information

NPI: 1316015258
Provider Name (Legal Business Name): WEST SIDE MEDICAL SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 W 110TH ST SUITE 1D
NEW YORK NY
10025-2086
US

IV. Provider business mailing address

535 W 110TH ST SUITE 1D
NEW YORK NY
10025-2086
US

V. Phone/Fax

Practice location:
  • Phone: 212-864-8888
  • Fax: 212-864-8928
Mailing address:
  • Phone: 212-864-8888
  • Fax: 212-864-8928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number189813
License Number StateNY

VIII. Authorized Official

Name: DR. JOSEPH P YOE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 212-864-8888