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General NPI Number Information
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NPI Number | 1225736705
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Entity Type | Organization
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Legal Business Name | 180 DEGREES MEDICAL PLLC
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Dates
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Enumeration Date | 02/23/2023
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Last Update Date | 09/26/2023
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Provider Practice Location Address
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Address Line | 620 MALCOLM X BLVD APT 11D
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City | NEW YORK
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State | NY
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Zip | 10037-1206
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Country | US
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Telephone | 251-599-2388
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Fax |
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Provider Business Mailing Address
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Address Line | 620 MALCOLM X BLVD APT 11D
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City | NEW YORK
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State | NY
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Zip | 10037-1206
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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 | OWNER
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Name | DR. TREMAINE JAMAR WRIGHT
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Credential | DO
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Telephone | 251-599-2388
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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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Taxonomy #2
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Taxonomy Code | 2083B0002X
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Taxonomy Name | Obesity Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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