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General NPI Number Information
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NPI Number | 1740504679
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Entity Type | Organization
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Legal Business Name | YORKVILLE MEDICAL ASSOCIATES PLLC
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Dates
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Enumeration Date | 03/22/2010
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Last Update Date | 04/12/2010
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Provider Practice Location Address
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Address Line | 311 E 79TH ST
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City | NEW YORK
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State | NY
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Zip | 10075-0999
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Country | US
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Telephone | 212-996-6633
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Fax | 212-996-6677
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Provider Business Mailing Address
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Address Line | 311 E 79TH ST
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City | NEW YORK
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State | NY
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Zip | 10075-0999
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Country | US
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Telephone | 212-996-6633
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Fax | 212-996-6677
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Authorized Official
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Title or Position | PRESIDENT
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Name | LAWRENCE BRUCE COHEN
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Credential | M.D.
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Telephone | 212-996-6633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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