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General NPI Number Information
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NPI Number | 1447506225
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Entity Type | Organization
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Legal Business Name | GRAND CENTRAL MEDICAL P.C.
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Dates
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Enumeration Date | 07/30/2012
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Last Update Date | 07/30/2012
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Provider Practice Location Address
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Address Line | 18 E 41ST ST SUITE 406
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City | NEW YORK
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State | NY
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Zip | 10017-6222
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Country | US
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Telephone | 646-692-4080
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Fax |
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Provider Business Mailing Address
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Address Line | 18 E 41ST ST SUITE 406
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City | NEW YORK
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State | NY
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Zip | 10017-6222
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Country | US
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Telephone | 646-692-4080
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MS. HYOUNJOO CHO
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Credential |
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Telephone | 917-828-5711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 145071
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License Number State | NY
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