Healthcare Provider Details

I. General information

NPI: 1982846762
Provider Name (Legal Business Name): YORK AVENUE MEDICAL SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2009
Last Update Date: 03/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1751 YORK AVE
NEW YORK NY
10128-6828
US

IV. Provider business mailing address

1751 YORK AVE
NEW YORK NY
10128-6828
US

V. Phone/Fax

Practice location:
  • Phone: 212-369-2490
  • Fax: 212-831-3031
Mailing address:
  • Phone: 212-369-2490
  • Fax: 212-831-3031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207ZC0006X
TaxonomyClinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES GEORGE
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 212-369-2490