=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700780202
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | 99 MADISON MEDICAL PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/07/2026
-----------------------------------------------------
Last Update Date | 10/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 99 MADISON AVE STE 419
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10016-7419
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-404-6059
-----------------------------------------------------
Fax | 646-558-4299
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 99 MADISON AVE STE 419
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10016-7419
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-404-6059
-----------------------------------------------------
Fax | 646-558-4299
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGEMENT
-----------------------------------------------------
Name | SOFIA RAJABS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 646-404-6059
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------