Healthcare Provider Details

I. General information

NPI: 1750450748
Provider Name (Legal Business Name): EUGENE WEST MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 CENTRAL PARK WEST SUITE 15
NEW YORK NY
10023-4198
US

IV. Provider business mailing address

115 CENTRAL PARK W SUITE 15
NEW YORK NY
10023-4198
US

V. Phone/Fax

Practice location:
  • Phone: 212-496-6510
  • Fax: 212-496-6582
Mailing address:
  • Phone: 212-496-6510
  • Fax: 212-496-6582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number191552
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number191552
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code208U00000X
TaxonomyClinical Pharmacology Physician
License Number191552
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: