MEDICARE: FACE2FACE HEALTH MEDICAL, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	103TF0000X	Family Psychologist
3	104100000X	Social Worker
4	111N00000X	Chiropractor
5	122300000X	Dentist
6	133NN1002X	Nutrition Education Nutritionist
7	133V00000X	Registered Dietitian
8	163W00000X	Registered Nurse
9	174H00000X	Health Educator
10	175F00000X	Naturopath
11	208000000X	Pediatrics Physician
12	225100000X	Physical Therapist
13	225X00000X	Occupational Therapist
14	235Z00000X	Speech-Language Pathologist
15	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1154770451
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FACE2FACE HEALTH MEDICAL, PLLC

Provider Business Mailing Address
First Line	:	350 E 79TH ST APT 34B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10075-9209
Country	:	US
Telephone Number	:	917-822-7424
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 E 79TH ST APT 34B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10075-9209
Country	:	US
Telephone Number	:	917-822-7424
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT, FOUNDER AND CEO
Name	:	DR. AMI SHAH
Credential	:	M.D.
Telephone Number	:	917-822-7424

Provider Enumeration Date	:	06/07/2016
Last Update Date	:	06/07/2016

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