Provider Demographics
NPI:1033402656
Name:ADAM K PENSTEIN MD PLLC
Entity Type:Organization
Organization Name:ADAM K PENSTEIN MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:PENSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-517-5171
Mailing Address - Street 1:116 E 66TH ST
Mailing Address - Street 2:OFFICE-A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6547
Mailing Address - Country:US
Mailing Address - Phone:646-470-6828
Mailing Address - Fax:212-517-5181
Practice Address - Street 1:116 E 66TH ST
Practice Address - Street 2:OFFICE-A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6547
Practice Address - Country:US
Practice Address - Phone:646-470-6828
Practice Address - Fax:212-517-5181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty