Healthcare Provider Details

I. General information

NPI: 1386018745
Provider Name (Legal Business Name): PROFESSIONAL MONITORING AND TESTING ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2015
Last Update Date: 02/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 BROADWAY SUITE 1200
NEW YORK NY
10010
US

IV. Provider business mailing address

PO BOX 473
ITHACA NY
14851-0473
US

V. Phone/Fax

Practice location:
  • Phone: 212-228-4002
  • Fax:
Mailing address:
  • Phone: 212-228-4002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: JAMES JANKOWSKI
Title or Position: CFO
Credential:
Phone: 212-228-4002