Provider Demographics
NPI:1265816359
Name:NEW YORK INTERNAL MEDICINE PC
Entity Type:Organization
Organization Name:NEW YORK INTERNAL MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ATTIA ALLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-746-9494
Mailing Address - Street 1:2818 STEINWAY ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-3349
Mailing Address - Country:US
Mailing Address - Phone:718-746-9494
Mailing Address - Fax:718-746-4963
Practice Address - Street 1:2818 STEINWAY ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-3349
Practice Address - Country:US
Practice Address - Phone:718-746-9494
Practice Address - Fax:718-746-4963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY267642-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG100097256Medicare PIN