Provider Demographics
NPI:1164671418
Name:METRO PHYSICIAN ASSOCIATES LLP
Entity Type:Organization
Organization Name:METRO PHYSICIAN ASSOCIATES LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:HERWIG
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:212-475-8066
Mailing Address - Street 1:PO BOX 1816
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10159-1816
Mailing Address - Country:US
Mailing Address - Phone:212-475-8066
Mailing Address - Fax:212-475-4175
Practice Address - Street 1:13259 41ST RD
Practice Address - Street 2:SUITE CB
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-4257
Practice Address - Country:US
Practice Address - Phone:212-475-8066
Practice Address - Fax:212-475-4175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY114071207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Single Specialty