Healthcare Provider Details

I. General information

NPI: 1922093814
Provider Name (Legal Business Name): EPHRAIM M OVITSH MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2005
Last Update Date: 12/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W 20TH ST SUITE 105
NEW YORK NY
10011-3558
US

IV. Provider business mailing address

1000 E 22ND ST
BROOKLYN NY
11210-3610
US

V. Phone/Fax

Practice location:
  • Phone: 212-647-8560
  • Fax: 212-647-8583
Mailing address:
  • Phone: 212-647-8560
  • Fax: 212-647-8583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: EPHRAIM M OVITSH
Title or Position: OWNER
Credential: MD
Phone: 212-647-8560