Provider Demographics
NPI:1205375557
Name:WEST SIDE PHYSICIANS OF NYC, PLLC
Entity Type:Organization
Organization Name:WEST SIDE PHYSICIANS OF NYC, PLLC
Other - Org Name:MIDOC URGENT CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VINO
Authorized Official - Middle Name:
Authorized Official - Last Name:PALLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-757-2015
Mailing Address - Street 1:715 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-7359
Mailing Address - Country:US
Mailing Address - Phone:212-757-3859
Mailing Address - Fax:212-757-2815
Practice Address - Street 1:715 9TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-7359
Practice Address - Country:US
Practice Address - Phone:212-757-3859
Practice Address - Fax:212-757-2815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care