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General NPI Number Information
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NPI Number | 1295500627
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Entity Type | Organization
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Legal Business Name | OUTLAST HEALTH P.A
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Dates
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Enumeration Date | 11/15/2023
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Last Update Date | 11/15/2023
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Provider Practice Location Address
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Address Line | 550 W 54TH ST APT 2120
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City | NEW YORK
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State | NY
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Zip | 10019-4725
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Country | US
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Telephone | 646-925-7037
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Fax |
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Provider Business Mailing Address
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Address Line | 550 W 54TH ST APT 2120
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City | NEW YORK
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State | NY
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Zip | 10019-4725
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Country | US
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Telephone | 646-925-7037
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GERMAN ECHEVERRY
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Credential | MD
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Telephone | 954-903-8072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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