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General NPI Number Information
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NPI Number | 1104093442
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Entity Type | Organization
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Legal Business Name | NEW YORK ENDOCRINE ASSOCIATES PLLC
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Dates
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Enumeration Date | 05/15/2008
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Last Update Date | 05/15/2008
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Provider Practice Location Address
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Address Line | 35 E 85TH ST
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City | NEW YORK
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State | NY
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Zip | 10028-0954
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Country | US
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Telephone | 212-879-5933
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Fax | 212-861-7429
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Provider Business Mailing Address
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Address Line | 35 E 85TH ST
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City | NEW YORK
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State | NY
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Zip | 10028-0954
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Country | US
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Telephone | 212-879-5933
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Fax | 212-861-7429
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ZACHARY T BLOOMGARDEN
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Credential | M.D.
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Telephone | 212-879-5933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 0005291
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 101019
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 125739
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License Number State | NY
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