Healthcare Provider Details

I. General information

NPI: 1902027105
Provider Name (Legal Business Name): EVA BOTSTEIN GRIEPP MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 UNITED NATIONS PLZ APT 11F
NEW YORK NY
10017-1810
US

IV. Provider business mailing address

860 UNITED NATIONS PLZ APT 11F
NEW YORK NY
10017-1810
US

V. Phone/Fax

Practice location:
  • Phone: 212-355-5092
  • Fax: 212-355-3599
Mailing address:
  • Phone: 212-355-5092
  • Fax: 212-355-3599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080H0002X
TaxonomyPediatric Hospice and Palliative Medicine Physician
License Number141431
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: