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General NPI Number Information
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NPI Number | 1164048021
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Entity Type | Organization
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Legal Business Name | PARK EAST MEDICAL PLLC
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Dates
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Enumeration Date | 06/17/2020
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Last Update Date | 06/17/2020
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Provider Practice Location Address
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Address Line | 870 5TH AVE APT 1B
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City | NEW YORK
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State | NY
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Zip | 10065-4907
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Country | US
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Telephone | 212-988-1444
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Fax |
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Provider Business Mailing Address
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Address Line | 870 5TH AVE APT 1B
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City | NEW YORK
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State | NY
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Zip | 10065-4907
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Country | US
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Telephone | 129-881-4442
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ELIF SECKIN
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Credential |
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Telephone | 718-915-0408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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