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General NPI Number Information
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NPI Number | 1134615016
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Entity Type | Organization
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Legal Business Name | CITY INTEGRATIVE MEDICINE PC
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Dates
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Enumeration Date | 07/03/2018
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 438 W 51ST ST
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City | NEW YORK
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State | NY
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Zip | 10019-6503
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Country | US
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Telephone | 973-400-1716
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Fax |
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Provider Business Mailing Address
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Address Line | 44 STATE RT 23 STE 15B
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City | RIVERDALE
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State | NJ
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Zip | 07457-1603
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. KATHY IODICE
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Credential |
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Telephone | 973-400-1716
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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