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NPI Code Detail

MEDICARE: NEW YORK SOCIETY FOR RELIEF OF THE RUPTURED AND CRIPPLED MAINTAINING T

MEDICARE: NEW YORK SOCIETY FOR RELIEF OF THE RUPTURED AND CRIPPLED MAINTAINING T
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
1261QM1200XMagnetic Resonance Imaging (MRI) Clinic/Center
2261QR0400XRehabilitation Clinic/Center
3261QR0200XRadiology Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487200408
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW YORK SOCIETY FOR RELIEF OF THE RUPTURED AND CRIPPLED MAINTAINING T
Provider Business Mailing Address
First Line : 535 E 70TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10021-4823
Country : US
Telephone Number : 212-774-2668
Fax Number : 646-797-8668
Provider Business Practice Location Address
First Line : 148 39TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11232-2550
Country : US
Telephone Number : 212-774-2668
Fax Number : 646-797-8668
Authorized Official
Title or Position : EXECUTIVE V.P. & CFO
Name : STACEY MALAKOFF
Credential :
Telephone Number : 212-606-1000
Provider Enumeration Date : 08/15/2019
Last Update Date : 01/31/2023

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