Healthcare Provider Details

I. General information

NPI: 1932619608
Provider Name (Legal Business Name): NYC MEDICAL INFUSION PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2017
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 E 96TH ST
NEW YORK NY
10128-6200
US

IV. Provider business mailing address

1047 SURF AVE FL 2
BROOKLYN NY
11224-2810
US

V. Phone/Fax

Practice location:
  • Phone: 212-776-9090
  • Fax: 800-540-1852
Mailing address:
  • Phone: 212-776-9090
  • Fax: 800-540-1852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number224301
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number045710
License Number StateNY

VIII. Authorized Official

Name: ROBERT ROTEMAN
Title or Position: CHIEF MEDICAL OFFICER
Credential:
Phone: 212-776-9090