Provider Demographics
NPI:1396037305
Name:MIDTOWN ALLERGY AND ARTHRITIS CARE P.C.
Entity Type:Organization
Organization Name:MIDTOWN ALLERGY AND ARTHRITIS CARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:J
Authorized Official - Last Name:AST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-725-7027
Mailing Address - Street 1:35 E 30TH ST
Mailing Address - Street 2:SUITE #1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-7325
Mailing Address - Country:US
Mailing Address - Phone:212-725-7027
Mailing Address - Fax:212-725-0433
Practice Address - Street 1:35 EAST 30TH ST
Practice Address - Street 2:SUITE #1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-7308
Practice Address - Country:US
Practice Address - Phone:212-725-7027
Practice Address - Fax:212-725-0433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-09
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY178311174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY178311OtherLICENSE
NY178311OtherLICENSE
NYF25472Medicare UPIN