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MEDICAL ASSOCIATE OF WALL STREET P.C. NPI 1912272592


NPI Information

NPI: 1912272592
Provider Name: MEDICAL ASSOCIATE OF WALL STREET, P.C.
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 33D2086224

Address:
6 MAIDEN LN RM 500
NEW YORK, NY
ZIP 10038
Phone: (212) 233-3040
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MEDICAL ASSOCIATE OF WALL STREET, P.C. is a multi-specialty clinic center in New York, NY. MEDICAL ASSOCIATE OF WALL STREET, P.C. NPI is 1912272592. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6 MAIDEN LN RM 500
NEW YORK, NY
ZIP 10038-140
Phone: (212) 233-3040
Fax: (212) 349-7529

The provider's authorized official is Glenn Gandelman .
The authorized official title is Chief Executive Officer and has the following contact phone number (212) 233-3040.

The CLIA number assigned to this NPI record is 33D2086224 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/15/2012 and was last updated on 9/20/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineNo
2207RC0000XInternal MedicineCardiovascular DiseaseNo
3261QM1300XClinic/CenterMulti-SpecialtyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.