MEDICARE: PERFORMANCE MEDICAL SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	X005160-2	NY
2	171100000X	Acupuncturist	229782-A	NY
3	261QM2500X	Medical Specialty Clinic/Center	241676-1	NY

General Provider Information

NPI Number	:	1003121492
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERFORMANCE MEDICAL SERVICES

Provider Business Mailing Address
First Line	:	70 E 55TH ST
Second Line	:	2ND FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10022-3222
Country	:	US
Telephone Number	:	212-486-8616
Fax Number	:	212-486-8621

Provider Business Practice Location Address
First Line	:	570 LEXINGTON AVE
Second Line	:	SUITE 1903
City	:	NEW YORK
State	:	NY
Zip	:	10022-6837
Country	:	US
Telephone Number	:	212-486-8616
Fax Number	:	212-486-8621

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. MARVELL SCOTT
Credential	:	MD
Telephone Number	:	212-486-8616

Provider Enumeration Date	:	08/10/2010
Last Update Date	:	02/27/2014

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Directions to “PERFORMANCE MEDICAL SERVICES ” Practice Location

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