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NPI Code Detail

MEDICARE: EASTWEST MEDICINE SERVICE PC

MEDICARE: EASTWEST MEDICINE SERVICE PC
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
1174400000XSpecialist162059NY

General Provider Information

NPI Number : 1316239700
Entity Type Code : Organization
Provider Name (Legal Business Name) : EASTWEST MEDICINE SERVICE PC
Provider Business Mailing Address
First Line : 137 5TH AVE FL 7
Second Line :
City : NEW YORK
State : NY
Zip : 10010-7142
Country : US
Telephone Number : 609-879-6243
Fax Number : 609-879-6243
Provider Business Practice Location Address
First Line : 115 E 23RD ST FL 10
Second Line :
City : NEW YORK
State : NY
Zip : 10010-4558
Country : US
Telephone Number : 212-928-8383
Fax Number :
Authorized Official
Title or Position : OFFICE MANAGER
Name : RENEE CRANMER
Credential :
Telephone Number : 609-879-6243
Provider Enumeration Date : 05/04/2011
Last Update Date : 11/12/2019

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Directions to “EASTWEST MEDICINE SERVICE PC ” Practice Location

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