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General NPI Number Information
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NPI Number | 1477196236
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Entity Type | Organization
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Legal Business Name | MIDTOWN APPLIED MEDICINE,PC
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Dates
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Enumeration Date | 10/24/2019
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Last Update Date | 10/24/2019
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Provider Practice Location Address
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Address Line | 244 5TH AVENU, STE 2095 STE 2095
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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 | 646-673-3375
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Fax |
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Provider Business Mailing Address
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Address Line | 244 5TH AVENU, STE 2095 STE 2095
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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 | 646-673-3375
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | ZLATIN IVANOV
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Credential | M.D.
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Telephone | 646-673-3375
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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