Healthcare Provider Details

I. General information

NPI: 1912004284
Provider Name (Legal Business Name): CITY MEDICAL P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 E 58TH ST SUITE 1101
NEW YORK NY
10022-1236
US

IV. Provider business mailing address

131 CRAIG RD
HILLSDALE NJ
07642-1054
US

V. Phone/Fax

Practice location:
  • Phone: 212-755-7022
  • Fax: 212-755-7021
Mailing address:
  • Phone: 201-888-0021
  • Fax: 201-722-3560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GARY STEVEN HERRING
Title or Position: PRESIDENT
Credential: M.D.
Phone: 201-888-0021