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General NPI Number Information
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NPI Number | 1992257034
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Entity Type | Organization
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Legal Business Name | NC MEDICAL OF NY PC
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Dates
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Enumeration Date | 10/25/2016
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Last Update Date | 09/01/2023
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Provider Practice Location Address
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Address Line | 1221 AVENUE OF THE AMERICAS RM 50073
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City | NEW YORK
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State | NY
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Zip | 10020-1001
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Country | US
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Telephone | 212-819-8955
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Fax |
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Provider Business Mailing Address
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Address Line | 10 W MARKET ST STE 2900
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City | INDIANAPOLIS
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State | IN
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Zip | 46204-2964
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Country | US
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Telephone | 802-857-0400
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Fax |
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Authorized Official
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Title or Position | SR. VP CORPORATE MEDICAL DIRECTOR
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Name | TERRY LAYMAN
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Credential | DR.
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Telephone | 377-522-0844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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