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General NPI Number Information
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NPI Number | 1023459013
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Entity Type | Organization
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Legal Business Name | EAST 57TH MEDICAL ASSOCIATES PLLC
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Dates
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Enumeration Date | 07/08/2013
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Last Update Date | 07/08/2013
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Provider Practice Location Address
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Address Line | 227 E 56TH ST SUITE 203
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City | NEW YORK
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State | NY
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Zip | 10022-3754
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Country | US
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Telephone | 212-203-8477
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 158
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City | NEW YORK
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State | NY
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Zip | 10150-0158
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Country | US
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Telephone | 212-203-8744
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MS. RITA KICHENAMOURTY
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Credential |
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Telephone | 212-203-8744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 1833961
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License Number State | NY
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