Healthcare Provider Details

I. General information

NPI: 1629465034
Provider Name (Legal Business Name): TRIBECA MEDICAL SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2015
Last Update Date: 04/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 BROADWAY FL 2
NEW YORK NY
10007-2056
US

IV. Provider business mailing address

281 BROADWAY FL 2
NEW YORK NY
10007-2056
US

V. Phone/Fax

Practice location:
  • Phone: 646-596-7386
  • Fax:
Mailing address:
  • Phone: 646-596-7386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JONATHANN C. KUO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 646-596-7386