Provider Demographics
NPI:1093022782
Name:WESTEND MEDICAL SERVICES,PC
Entity Type:Organization
Organization Name:WESTEND MEDICAL SERVICES,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:INDIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAIRAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-865-7355
Mailing Address - Street 1:945 W END AVE
Mailing Address - Street 2:SUITE@1D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-3566
Mailing Address - Country:US
Mailing Address - Phone:212-865-7355
Mailing Address - Fax:212-865-7447
Practice Address - Street 1:945 W END AVE
Practice Address - Street 2:SUITE@1D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-3566
Practice Address - Country:US
Practice Address - Phone:212-865-7355
Practice Address - Fax:212-865-7447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-02
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY131920174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100037090Medicare PIN