Healthcare Provider Details

I. General information

NPI: 1003023912
Provider Name (Legal Business Name): MIDTOWN REPRODUCTIVE MEDICINE,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 MADISON AVE RM 4SW
NEW YORK NY
10016-5459
US

IV. Provider business mailing address

161 MADISON AVE RM 4SW
NEW YORK NY
10016-5459
US

V. Phone/Fax

Practice location:
  • Phone: 212-779-8576
  • Fax: 212-779-9174
Mailing address:
  • Phone: 212-779-8576
  • Fax: 212-779-9174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number129647
License Number StateNY

VIII. Authorized Official

Name: DR. MITCHELL ESSIG
Title or Position: OWNER
Credential: M.D.
Phone: 212-779-8576