MEDICARE: UNIMED HEALTH CARE 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
1	207Q00000X	Family Medicine Physician
2	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1952392763
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIMED HEALTH CARE PC

Provider Business Mailing Address
First Line	:	150 BROADWAY
Second Line	:	SUITE 714
City	:	NEW YORK
State	:	NY
Zip	:	10038-4381
Country	:	US
Telephone Number	:	212-964-5555
Fax Number	:	212-964-0474

Provider Business Practice Location Address
First Line	:	150 BROADWAY
Second Line	:	SUITE 714
City	:	NEW YORK
State	:	NY
Zip	:	10038-4381
Country	:	US
Telephone Number	:	212-964-5555
Fax Number	:	212-964-0474

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MIKHAIL FUKS
Credential	:	MD
Telephone Number	:	212-964-5555

Provider Enumeration Date	:	11/01/2005
Last Update Date	:	07/01/2009

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