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General NPI Number Information
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NPI Number | 1689809717
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Entity Type | Organization
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Legal Business Name | ENRIQUE ERGAS M D & THOMAS YOUM M D PC
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Dates
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Enumeration Date | 05/19/2009
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Last Update Date | 08/05/2010
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Provider Practice Location Address
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Address Line | 1056 5TH AVE
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City | NEW YORK
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State | NY
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Zip | 10028-0112
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Country | US
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Telephone | 212-348-3636
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Fax | 212-410-3338
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Provider Business Mailing Address
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Address Line | 1056 5TH AVE
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City | NEW YORK
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State | NY
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Zip | 10028-0112
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Country | US
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Telephone | 212-348-3636
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Fax | 212-410-3338
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Authorized Official
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Title or Position | OWNER
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Name | ENRIQUE ERGAS
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Credential | MD
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Telephone | 212-348-3636
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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 | 098228
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License Number State | NY
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