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General NPI Number Information
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NPI Number | 1043107592
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Entity Type | Organization
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Legal Business Name | MANHATTAN BODY MEDICAL, PLLC
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 201 E 65TH ST LOWER LEVEL
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City | NEW YORK
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State | NY
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Zip | 10065-6701
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Country | US
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Telephone | 212-879-4700
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Fax | 212-249-7580
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Provider Business Mailing Address
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Address Line | 255 E 74TH ST APT 29A
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City | NEW YORK
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State | NY
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Zip | 10021-3687
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Country | US
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Telephone | 212-879-4700
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | ROBERT SEGAL
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Credential | MD
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Telephone | 212-879-4700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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