Provider Demographics
NPI:1447782149
Name:THE IV MEDICAL DOCTOR, P.C
Entity Type:Organization
Organization Name:THE IV MEDICAL DOCTOR, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:NADELSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:844-843-4836
Mailing Address - Street 1:53 W 36TH ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-7903
Mailing Address - Country:US
Mailing Address - Phone:844-843-4836
Mailing Address - Fax:
Practice Address - Street 1:11400 W OLYMPIC BLVD
Practice Address - Street 2:SUITE 212
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1550
Practice Address - Country:US
Practice Address - Phone:844-843-4836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-31
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care