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General NPI Number Information
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NPI Number | 1124494794
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Entity Type | Organization
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Legal Business Name | HARLEM EXTENDED MEDICAL CARE PLLC
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Dates
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Enumeration Date | 08/18/2015
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Last Update Date | 08/18/2015
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Provider Practice Location Address
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Address Line | 85 W 118TH ST
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City | NEW YORK
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State | NY
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Zip | 10026-1903
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Country | US
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Telephone | 516-971-1824
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Fax |
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Provider Business Mailing Address
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Address Line | 85 W 118TH ST
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City | NEW YORK
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State | NY
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Zip | 10026-1903
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Country | US
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Telephone | 516-971-1824
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ARTHUR DOVE
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Credential | MD
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Telephone | 516-971-1824
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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 |
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License Number State |
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