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General NPI Number Information
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NPI Number | 1114290012
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Entity Type | Organization
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Legal Business Name | MYRON I BUCHMAN MDPCV
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Dates
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Enumeration Date | 02/23/2012
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Last Update Date | 02/23/2012
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Provider Practice Location Address
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Address Line | 117 EAST 72ND ST
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City | NEW YORK
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State | NY
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Zip | 10021
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Country | US
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Telephone | 212-861-1950
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Fax | 212-861-3253
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Provider Business Mailing Address
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Address Line | 117 EAST 72ND ST
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City | NEW YORK
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State | NY
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Zip | 10021
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Country | US
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Telephone | 212-861-1950
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Fax | 212-861-3253
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MYRON ISAAC BUCHMAN
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Credential | MD
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Telephone | 212-861-1950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 48761
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License Number State | NY
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