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General NPI Number Information
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NPI Number | 1376901298
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Entity Type | Organization
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Legal Business Name | VAMC
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Dates
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Enumeration Date | 02/06/2016
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Last Update Date | 02/06/2016
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Provider Practice Location Address
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Address Line | 300 E 34TH ST APT 8D
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City | NEW YORK
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State | NY
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Zip | 10016-5209
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Country | US
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Telephone | 646-404-0710
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Fax |
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Provider Business Mailing Address
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Address Line | 300 E 34TH ST APT 8D
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City | NEW YORK
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State | NY
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Zip | 10016-5209
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Country | US
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Telephone | 646-404-0710
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MARCEL KAGANOVSKAYA
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Credential |
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Telephone | 646-404-0710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 340371
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 340371
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 340371
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License Number State | NY
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