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1821167453

NPI Code Detail

MEDICARE: PATRICK G. NORTHUP MD

MEDICARE: PATRICK G. NORTHUP MD

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	207RG0100X	Gastroenterology Physician	25MA11514400	NJ
2	207RG0100X	Gastroenterology Physician	315458	NY
3	207RT0003X	Transplant Hepatology Physician	25MA11514400	NJ
4	207RT0003X	Transplant Hepatology Physician	315458	NY

General Provider Information

NPI Number	:	1821167453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK G. NORTHUP MD

Provider Business Mailing Address
First Line	:	14 WALL ST FL 9
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10005-2178
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	317 E 34TH ST FL 8
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-4910
Country	:	US
Telephone Number	:	212-263-8134
Fax Number	:	212-263-8157

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	04/29/2024

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Directions to “ PATRICK G. NORTHUP MD” Practice Location

Language	Start Address	Practice Location

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