Healthcare Provider Details

I. General information

NPI: 1487769782
Provider Name (Legal Business Name): ASQUAL GETANEH M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3682 BROADWAY
NEW YORK NY
10031-1526
US

IV. Provider business mailing address

213 W 136TH ST #3
NEW YORK NY
10030-2605
US

V. Phone/Fax

Practice location:
  • Phone: 212-926-6273
  • Fax:
Mailing address:
  • Phone: 917-647-8989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number209810
License Number StateNY

VIII. Authorized Official

Name: DR. ASQUAL GETANEH
Title or Position: OWNER
Credential: M.D.
Phone: 917-647-8989