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General NPI Number Information
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NPI Number | 1265530752
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Entity Type | Organization
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Legal Business Name | EAST RIVER MEDICAL, PLLC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 512 CHERRY ST BUILDING I
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City | BLUEFIELD
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State | WV
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Zip | 24701-3341
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Country | US
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Telephone | 304-324-2715
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Fax | 304-324-2774
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Provider Business Mailing Address
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Address Line | PO BOX 213
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City | BLUEFIELD
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State | WV
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Zip | 24701-0213
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Country | US
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Telephone | 304-324-2715
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Fax | 304-324-2774
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Authorized Official
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Title or Position | OWNER
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Name | MAYANK S AMIN
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Credential | MD
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Telephone | 304-324-2715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20921
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 19428
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 20602
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License Number State | WV
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 36628
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License Number State | WV
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