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CITY MEDICAL OF UPPER EAST SIDE PLLC NPI 1912760034


NPI Information

NPI: 1912760034
Provider Name: CITY MEDICAL OF UPPER EAST SIDE, PLLC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 33D2186966

Address:
363 WILLIS AVE
ROSLYN HEIGHTS, NY
ZIP 11577
Phone: (516) 430-5780
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CITY MEDICAL OF UPPER EAST SIDE, PLLC is a clinic center in Roslyn Heights, NY. The provider is 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). CITY MEDICAL OF UPPER EAST SIDE, PLLC NPI is 1912760034. The provider is registered as an organization entity type.

The provider's business location address is:

363 WILLIS AVE
ROSLYN HEIGHTS, NY
ZIP 11577-321
Phone: (516) 430-5780

The provider's authorized official is Jeffrey D Lebenger .
The authorized official title is Ceo and has the following contact phone number (908) 790-6567.

The CLIA number assigned to this NPI record is 33D2186966 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/1/2024 and was last updated on 2/1/2024.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterYes

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: 5/5/2024

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.