Provider Demographics
NPI:1083814974
Name:NEW YORK WALK-IN MEDICAL GROUP, PC
Entity Type:Organization
Organization Name:NEW YORK WALK-IN MEDICAL GROUP, PC
Other - Org Name:D/B/A DR WALK- IN MEDICAL CARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:ENDRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-955-0000
Mailing Address - Street 1:11 PENN PLAZA
Mailing Address - Street 2:SUITE 500
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011
Mailing Address - Country:US
Mailing Address - Phone:866-366-3060
Mailing Address - Fax:
Practice Address - Street 1:1627 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-7407
Practice Address - Country:US
Practice Address - Phone:866-366-3060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty