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General NPI Number Information
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NPI Number | 1477846368
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Entity Type | Organization
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Legal Business Name | MEDICAL RESEARCH ASSOCIATES
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Dates
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Enumeration Date | 05/25/2011
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Last Update Date | 05/25/2011
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Provider Practice Location Address
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Address Line | 19 BRADHURST AVE SUITE 3070
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City | HAWTHORNE
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State | NY
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Zip | 10532-2140
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Country | US
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Telephone | 914-372-7887
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Fax | 914-372-7884
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Provider Business Mailing Address
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Address Line | 19 BRADHURST AVE SUITE 3070
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City | HAWTHORNE
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State | NY
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Zip | 10532-2140
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Country | US
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Telephone | 914-372-7887
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Fax | 914-372-7884
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Authorized Official
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Title or Position | CHAIRMAN
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Name | DR. WILLIAM FISHMAN
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Credential | MD
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Telephone | 914-594-4384
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 2335191
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License Number State | NY
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