Healthcare Provider Details

I. General information

NPI: 1770534216
Provider Name (Legal Business Name): GEORGE L UNIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 E 61ST ST 8TH FLOOR
NEW YORK NY
10021-8183
US

IV. Provider business mailing address

115 E 61ST ST 8TH FLOOR
NEW YORK NY
10021-8183
US

V. Phone/Fax

Practice location:
  • Phone: 212-688-3710
  • Fax: 212-371-1932
Mailing address:
  • Phone: 212-688-3710
  • Fax: 212-371-1932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number097141
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: