Provider Demographics
NPI:1093958472
Name:NEW YORK PROFESSIONAL MEDICAL CARE,PC
Entity Type:Organization
Organization Name:NEW YORK PROFESSIONAL MEDICAL CARE,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAUDETTE
Authorized Official - Middle Name:O
Authorized Official - Last Name:TIRU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-213-8881
Mailing Address - Street 1:15 EAST 40TH STREET SUITE 1102
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-0401
Mailing Address - Country:US
Mailing Address - Phone:212-213-8881
Mailing Address - Fax:
Practice Address - Street 1:15 EAST 15TH STREET, SUITE 1102
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0401
Practice Address - Country:US
Practice Address - Phone:212-213-8881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02693543Medicaid
NYG83239Medicare UPIN
NY839081Medicare PIN