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General NPI Number Information
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NPI Number | 1871727834
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Entity Type | Organization
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Legal Business Name | DOUBLE CARE MEDICAL, P.C.
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Dates
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Enumeration Date | 05/06/2009
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Last Update Date | 10/05/2009
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Provider Practice Location Address
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Address Line | 400 FORT WASHINGTON AVE SUITE 1A
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City | NEW YORK
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State | NY
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Zip | 10033-6849
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Country | US
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Telephone | 212-795-9500
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Fax |
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Provider Business Mailing Address
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Address Line | 400 FORT WASHINGTON AVE SUITE 1A
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City | NEW YORK
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State | NY
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Zip | 10033-6849
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Country | US
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Telephone | 212-795-9500
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VLADIMIR MOLIVER
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Credential | M.D., D.O.
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Telephone | 212-795-9500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 213232
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 210590
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License Number State | NY
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