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General NPI Number Information
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NPI Number | 1851531776
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Entity Type | Organization
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Legal Business Name | SVCMC PHYSICIAN SERVICES
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Dates
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Enumeration Date | 03/05/2009
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Last Update Date | 03/05/2009
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Provider Practice Location Address
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Address Line | 170 W 12TH ST SUITE 5
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City | NEW YORK
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State | NY
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Zip | 10011-8202
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Country | US
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Telephone | 212-356-4400
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Fax | 212-356-4450
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Provider Business Mailing Address
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Address Line | 450 W 33RD ST PBS 12TH FL
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City | NEW YORK
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State | NY
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Zip | 10001-2603
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Country | US
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Telephone | 212-356-4400
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Fax | 212-356-4450
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Authorized Official
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Title or Position | SENIOR VP OF FINANCE
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Name | ROBERT MARIANI
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Credential |
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Telephone | 212-356-4405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207ZC0006X
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Taxonomy Name | Clinical Pathology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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