Healthcare Provider Details

I. General information

NPI: 1205836830
Provider Name (Legal Business Name): CENTER FOR SPECIALTY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 E 69TH ST
NEW YORK NY
10021-5016
US

IV. Provider business mailing address

50 E 69TH ST
NEW YORK NY
10021-5016
US

V. Phone/Fax

Practice location:
  • Phone: 212-249-8000
  • Fax: 212-249-7300
Mailing address:
  • Phone: 212-249-8000
  • Fax: 212-249-7300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number7002133R
License Number StateNY

VIII. Authorized Official

Name: MR. JAMES W SMITH
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 212-452-5177