Organization · NPI-2

Axoxa New Vitality Medical PC

Preventive Medicine, Public Health & General Preventive Medicine · New York, NY

NPI number1841654480
StatusActive
Last updated in NPPESApr 10, 2016

Details

NPI
1841654480
Entity type
Organization (NPI-2)
Legal business name
Axoxa New Vitality Medical PC
Organization subpart
No
Enumeration date
Apr 10, 2016
Last updated
Apr 10, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2083P0901X Preventive Medicine, Public Health & General Preventive Medicine249039NYYes

Practice location

61 E 86th St
New York, NY 10028-1068

Phone 646-862-7091

Mailing address

37 Sherman Ave
Staten Island, NY 10301-2301

Phone 347-857-0755

Authorized official

Juraj Lukac
Director
6468627091

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Preventive Medicine, Public Health & General Preventive Medicine providers in New York, NY