Healthcare Provider Details

I. General information

NPI: 1700780202
Provider Name (Legal Business Name): 99 MADISON MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 MADISON AVE STE 419
NEW YORK NY
10016-7419
US

IV. Provider business mailing address

99 MADISON AVE STE 419
NEW YORK NY
10016-7419
US

V. Phone/Fax

Practice location:
  • Phone: 646-404-6059
  • Fax: 646-558-4299
Mailing address:
  • Phone: 646-404-6059
  • Fax: 646-558-4299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: SOFIA RAJABS
Title or Position: MANAGEMENT
Credential:
Phone: 646-404-6059