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General NPI Number Information
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NPI Number | 1164398137
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Entity Type | Organization
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Legal Business Name | PERFORMANCE MEDICAL OF NY, P.C.
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Dates
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Enumeration Date | 10/15/2025
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 531 W 26TH ST FL 4
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City | NEW YORK
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State | NY
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Zip | 10001-5514
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Country | US
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Telephone | 855-621-2061
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Fax |
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Provider Business Mailing Address
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Address Line | 531 W 26TH ST FL 4
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City | NEW YORK
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State | NY
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Zip | 10001-5514
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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 | CHIEF ADMINISTRATIVE OFFICER
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Name | ALEX MATHER
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Credential |
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Telephone | 855-621-2061
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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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