Organization · NPI-2

501 West Medical, P.C.

Dermatology · New York, NY

NPI number1730136342
StatusActive
Last updated in NPPESJan 9, 2008

Details

NPI
1730136342
Entity type
Organization (NPI-2)
Legal business name
501 West Medical, P.C.
Organization subpart
No
Enumeration date
May 28, 2006
Last updated
Jan 9, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207N00000X Dermatology60-239556NYYes

Practice location

501 W 145th St
Suite 3
New York, NY 10031-5132

Phone 646-526-3641

Mailing address

501 W 145th St
Suite 3
New York, NY 10031-5132

Phone 646-526-3641

Authorized official

Kim Myruth Nichols
Managing Director
6465263641

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