Healthcare Provider Details

I. General information

NPI: 1700968070
Provider Name (Legal Business Name): HALEH MILANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 CENTRAL PARK WEST SUITE 1
NEW YORK NY
10023
US

IV. Provider business mailing address

200 RIVERSIDE BLVD #15D
NEW YORK NY
10069
US

V. Phone/Fax

Practice location:
  • Phone: 212-543-3400
  • Fax: 212-873-1960
Mailing address:
  • Phone: 212-543-3400
  • Fax: 212-873-1960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number196482
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: