Healthcare Provider Details

I. General information

NPI: 1922129360
Provider Name (Legal Business Name): THE WESTCHESTER MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915 CENTRAL PARK AVE # 25
YONKERS NY
10710-2949
US

IV. Provider business mailing address

210 WESTCHESTER AVE
WHITE PLAINS NY
10604-2901
US

V. Phone/Fax

Practice location:
  • Phone: 914-961-3437
  • Fax: 914-961-3589
Mailing address:
  • Phone: 914-681-3146
  • Fax: 914-682-6403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: SWAHILI HENRY
Title or Position: DIRECTOR OF PROVIDER ENROLLMENT
Credential:
Phone: 212-913-0828