Healthcare Provider Details

I. General information

NPI: 1093123762
Provider Name (Legal Business Name): NYU LANGONE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2014
Last Update Date: 07/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 E 20TH ST UNIT MA
NEW YORK NY
10009-8208
US

IV. Provider business mailing address

440 E 20TH ST UNIT MA
NEW YORK NY
10009-8208
US

V. Phone/Fax

Practice location:
  • Phone: 347-366-0518
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID CHIU
Title or Position: FELLOWSHIP DIRECTOR
Credential:
Phone: 212-263-7742