Provider Demographics
NPI:1093357568
Name:CITY MEDICAL HEALTHCARE ASSOCIATES PLLC
Entity Type:Organization
Organization Name:CITY MEDICAL HEALTHCARE ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:HAQUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-283-2099
Mailing Address - Street 1:565 W 125TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-3424
Mailing Address - Country:US
Mailing Address - Phone:212-470-1000
Mailing Address - Fax:800-604-6146
Practice Address - Street 1:3410 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-7408
Practice Address - Country:US
Practice Address - Phone:212-283-2099
Practice Address - Fax:800-604-6146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-16
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty