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General NPI Number Information
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NPI Number | 1639115629
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Entity Type | Organization
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Legal Business Name | EDWARD ATHANSIAN MD PC
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 523 E 72ND ST
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City | NEW YORK
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State | NY
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Zip | 10021-4099
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Country | US
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Telephone | 212-606-1962
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Fax |
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Provider Business Mailing Address
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Address Line | 535 E 70TH ST
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City | NEW YORK
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State | NY
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Zip | 10021-4872
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Country | US
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Telephone | 212-606-1962
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | EDWARD ATHANASIAN
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Credential | MD
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Telephone | 212-606-1962
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | 1809321
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License Number State | NY
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