Provider Demographics
NPI:1033588140
Name:MADISON SQUARE COMPREHENSIVE MEDICAL CARE, PLLC
Entity Type:Organization
Organization Name:MADISON SQUARE COMPREHENSIVE MEDICAL CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-533-2400
Mailing Address - Street 1:51 E 25TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-2945
Mailing Address - Country:US
Mailing Address - Phone:212-533-2400
Mailing Address - Fax:212-533-6607
Practice Address - Street 1:51 E 25TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-2945
Practice Address - Country:US
Practice Address - Phone:212-533-2400
Practice Address - Fax:212-533-6607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-18
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty