UPPER WEST SIDE MEDICAL DOCTOR PLLC


Address: 46 W 86th St Ste 1a, New York, NY 10024-3633
Phone: 9089621000

UPPER WEST SIDE MEDICAL DOCTOR PLLC (NPI# 1912417254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1912417254
Entity Type Organization
Organization Name UPPER WEST SIDE MEDICAL DOCTOR PLLC
Practice Address 46 W 86th St Ste 1a
New York
NY 10024-3633
Mailing Address 46 W 86th St
New York
NY 10024-3633
Practice Telephone 9089621000
Practice Fax Number 9089621000
Mailing Telephone 7324296513
Mailing Fax Number 9174721525
Enumeration Date 2017-09-30
Last Update Date 2017-12-05
Authorized Official Name BHAVANA KRANTHI (OWNER)
Authorized Official Telephone 7324296513
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261Q00000X Clinic/Center Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
NY NY STATE LICENSE 287857 01

Office Location

Street Address 46 W 86TH ST STE 1A
City NEW YORK
State NY
Zip Code 10024-3633

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Taxonomy Information

Taxonomy Code 261Q00000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center

Taxonomy Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

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Competitor

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City NEW YORK
Zip Code 10024

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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