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General NPI Number Information
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NPI Number | 1043639834
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Entity Type | Organization
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Legal Business Name | DOWNTOWN NYC MEDICAL PC
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Dates
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Enumeration Date | 04/09/2014
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Last Update Date | 04/09/2014
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Provider Practice Location Address
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Address Line | 130 WILLIAM ST SUITE 904
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City | NEW YORK
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State | NY
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Zip | 10038-3806
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Country | US
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Telephone | 212-962-2262
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Fax | 212-962-7472
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Provider Business Mailing Address
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Address Line | 130 WILLIAM ST SUITE 904
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City | NEW YORK
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State | NY
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Zip | 10038-3806
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Country | US
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Telephone | 212-962-2262
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Fax | 212-962-7472
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Authorized Official
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Title or Position | OWNER
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Name | GAZELLE A CRAIG
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Credential | D.O
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Telephone | 212-962-2262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 252279
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License Number State | NY
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