Healthcare Provider Details

I. General information

NPI: 1437592839
Provider Name (Legal Business Name): CWERN-HSU MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2013
Last Update Date: 04/01/2021
Certification Date: 04/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 E 31ST ST RM 701
NEW YORK NY
10016-6821
US

IV. Provider business mailing address

36 E 31ST ST RM 701
NEW YORK NY
10016-6821
US

V. Phone/Fax

Practice location:
  • Phone: 212-751-9714
  • Fax: 212-832-1821
Mailing address:
  • Phone: 212-751-9714
  • Fax: 212-832-1821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: MISS ROBIN HAWKINS
Title or Position: BILLING MANAGER
Credential:
Phone: 212-751-9714