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General NPI Number Information
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NPI Number | 1831496934
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Entity Type | Organization
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Legal Business Name | 98 PARK MEDICAL PC
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Dates
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Enumeration Date | 02/25/2011
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Last Update Date | 04/18/2011
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Provider Practice Location Address
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Address Line | 417 E 116TH ST APT 3
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City | NEW YORK
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State | NY
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Zip | 10029-1637
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Country | US
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Telephone | 646-351-3462
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Fax |
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Provider Business Mailing Address
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Address Line | 417 E 116TH ST APT 3
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City | NEW YORK
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State | NY
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Zip | 10029-1637
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Country | US
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Telephone | 646-351-3462
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JANET J ARRIBAS
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Credential | DO
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Telephone | 646-351-3462
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 2550161
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License Number State | NY
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