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General NPI Number Information
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NPI Number | 1639367238
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Entity Type | Organization
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Legal Business Name | PARK EAST ENDOCRINOLOGY PC
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 10/09/2007
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Provider Practice Location Address
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Address Line | 110 E 59TH ST SUITE 10C
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City | NEW YORK
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State | NY
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Zip | 10022-1304
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Country | US
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Telephone | 212-353-3636
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Fax |
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Provider Business Mailing Address
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Address Line | 110 E 59TH ST SUITE 10C
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City | NEW YORK
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State | NY
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Zip | 10022-1304
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Country | US
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Telephone | 212-353-3636
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ETAH KURLAND
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Credential | MD
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Telephone | 212-353-3636
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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 | 162758
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License Number State | NY
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