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General NPI Number Information
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NPI Number | 1245600717
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Entity Type | Organization
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Legal Business Name | GOTHAM SURGICAL, PLLC
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Dates
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Enumeration Date | 09/28/2015
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Last Update Date | 09/28/2015
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Provider Practice Location Address
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Address Line | 60 E 56TH ST
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City | NEW YORK
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State | NY
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Zip | 10022-3204
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Country | US
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Telephone | 212-750-7100
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Fax | 212-750-7101
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Provider Business Mailing Address
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Address Line | 60 E 56TH ST
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City | NEW YORK
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State | NY
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Zip | 10022-3204
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Country | US
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Telephone | 212-750-7100
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Fax | 212-750-7101
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PHILIP JAY MILLER
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Credential | M.D.
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Telephone | 212-750-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 182720
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License Number State | NY
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