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General NPI Number Information
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NPI Number | 1396036505
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Entity Type | Organization
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Legal Business Name | NYC OSTEPATHIC, PLLC
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Dates
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Enumeration Date | 04/21/2011
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Last Update Date | 04/21/2011
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Provider Practice Location Address
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Address Line | 244 5 AVENUE, STE G242
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City | NEW YORK
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State | NY
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Zip | 10001
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Country | US
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Telephone | 646-938-3931
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Fax |
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Provider Business Mailing Address
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Address Line | 2638 BROWN STREET
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City | BROOKLYN
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State | NY
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Zip | 11235
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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 | DO
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Name | LILIA GORODINSKY
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Credential |
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Telephone | 646-938-3931
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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 | 258147
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License Number State | NY
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