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NPI Code Detail

MEDICARE: EAST MANHATTAN MEDICAL SERVICES,PC

MEDICARE: EAST MANHATTAN MEDICAL SERVICES,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
1174400000XSpecialist198210-1NY

General Provider Information

NPI Number : 1750615381
Entity Type Code : Organization
Provider Name (Legal Business Name) : EAST MANHATTAN MEDICAL SERVICES,PC
Provider Business Mailing Address
First Line : 3 E 83RD ST
Second Line :
City : NEW YORK
State : NY
Zip : 10028-0459
Country : US
Telephone Number : 212-845-9255
Fax Number :
Provider Business Practice Location Address
First Line : 3 E 83RD ST
Second Line :
City : NEW YORK
State : NY
Zip : 10028-0459
Country : US
Telephone Number : 212-845-9255
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. PETER DISTLER
Credential : MD
Telephone Number : 212-845-9255
Provider Enumeration Date : 09/30/2009
Last Update Date : 11/16/2010

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Directions to “EAST MANHATTAN MEDICAL SERVICES,PC ” Practice Location

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