Provider Demographics
NPI:1275962201
Name:UNIVERSAL VIP MEDICAL SERVICES PLLC
Entity Type:Organization
Organization Name:UNIVERSAL VIP MEDICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:OCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-666-7397
Mailing Address - Street 1:PO BOX 520589
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11352-0589
Mailing Address - Country:US
Mailing Address - Phone:718-666-7397
Mailing Address - Fax:718-374-3115
Practice Address - Street 1:74-01 4TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-2541
Practice Address - Country:US
Practice Address - Phone:718-666-7397
Practice Address - Fax:718-374-3115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-12
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty