Healthcare Provider Details

I. General information

NPI: 1356741748
Provider Name (Legal Business Name): MOBILE HEALTH MEDICAL SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2014
Last Update Date: 09/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 W 36TH ST 9TH FL
NEW YORK NY
10018-7529
US

IV. Provider business mailing address

229 W 36TH ST 9TH FL
NEW YORK NY
10018-7529
US

V. Phone/Fax

Practice location:
  • Phone: 212-695-5122
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANDREW SHULMAN
Title or Position: CEO
Credential:
Phone: 646-625-3003