Healthcare Provider Details

I. General information

NPI: 1942465828
Provider Name (Legal Business Name): AMERICAN MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2008
Last Update Date: 07/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

928 BROADWAY SUITE 805
NEW YORK NY
10010-6008
US

IV. Provider business mailing address

928 BROADWAY SUITE 805
NEW YORK NY
10010-6008
US

V. Phone/Fax

Practice location:
  • Phone: 212-529-4900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number185414
License Number StateNY

VIII. Authorized Official

Name: DR. RONNY CHADI
Title or Position: DIRECTOR
Credential: MD
Phone: 212-529-4900