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General NPI Number Information
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NPI Number | 1174089056
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Entity Type | Organization
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Legal Business Name | CITY MEDICAL OF UPPER EAST SIDE, PLLC
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Dates
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Enumeration Date | 02/15/2019
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Last Update Date | 09/11/2024
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Provider Practice Location Address
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Address Line | 216 E 14TH ST STE B
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City | NEW YORK
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State | NY
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Zip | 10003-4105
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Country | US
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Telephone | 855-924-8963
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Fax | 844-626-2847
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Provider Business Mailing Address
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Address Line | 1345 AVENUE OF THE AMERICAS FL 8
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City | NEW YORK
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State | NY
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Zip | 10105-0018
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Country | US
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Telephone | 908-588-3635
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF PAYMENT SOLUTIONS
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Name | SWAHILI HENRY
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Credential |
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Telephone | 908-988-0482
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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