Healthcare Provider Details

I. General information

NPI: 1821087529
Provider Name (Legal Business Name): PARK EAST GYNECOLOGY & SURGERY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 10/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

872 5TH AVE
NEW YORK NY
10021-4953
US

IV. Provider business mailing address

872 5TH AVE
NEW YORK NY
10021-4953
US

V. Phone/Fax

Practice location:
  • Phone: 212-988-1444
  • Fax: 212-988-1755
Mailing address:
  • Phone: 212-988-1444
  • Fax: 212-988-1755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number157705
License Number StateNY

VIII. Authorized Official

Name: DR. TAMER A. SECKIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 212-988-1444