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General NPI Number Information
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NPI Number | 1104281245
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Entity Type | Organization
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Legal Business Name | WESTSIDE ONCOLOGY MEDICAL ASSOCIATES, P.L.L.C.
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Dates
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Enumeration Date | 12/16/2015
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Last Update Date | 12/16/2015
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Provider Practice Location Address
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Address Line | 521 W 57TH ST 4TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10019-2929
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Country | US
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Telephone | 551-996-4280
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Fax | 551-996-0729
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Provider Business Mailing Address
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Address Line | 521 W 57TH ST 4TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10019-2929
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Country | US
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Telephone | 557-996-5848
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Fax | 551-996-8578
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. ANDREW L. PECORA
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Credential | M.D.
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Telephone | 551-996-5900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 1603621
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License Number State | NY
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