Provider Demographics
NPI:1508022591
Name:425 MEDICAL ASSOCIATES PC
Entity Type:Organization
Organization Name:425 MEDICAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LAUFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-265-9866
Mailing Address - Street 1:425 W 59TH ST
Mailing Address - Street 2:SUITE 4A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1104
Mailing Address - Country:US
Mailing Address - Phone:212-265-9866
Mailing Address - Fax:212-977-9111
Practice Address - Street 1:425 W 59TH ST
Practice Address - Street 2:SUITE 4A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1104
Practice Address - Country:US
Practice Address - Phone:212-265-9866
Practice Address - Fax:212-977-9111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY153609207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty