Healthcare Provider Details

I. General information

NPI: 1982087896
Provider Name (Legal Business Name): PARKMED NYC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2015
Last Update Date: 07/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 2ND AVE 6TH FLOOR
NEW YORK NY
10017-4709
US

IV. Provider business mailing address

800 2ND AVE 6TH FLOOR
NEW YORK NY
10017-4709
US

V. Phone/Fax

Practice location:
  • Phone: 212-686-6066
  • Fax:
Mailing address:
  • Phone: 212-686-6066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL M MOLAEI
Title or Position: PRESIDENT/EXECUTIVE OFFICER
Credential: M.D.
Phone: 212-686-6066