Provider Demographics
NPI:1518049782
Name:OWEN, RANDALL P (MD)
Entity Type:Individual
Prefix:
First Name:RANDALL
Middle Name:P
Last Name:OWEN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:530 E 84TH ST
Mailing Address - Street 2:APT 2-S
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-7319
Mailing Address - Country:US
Mailing Address - Phone:212-241-1657
Mailing Address - Fax:212-202-4703
Practice Address - Street 1:5 E 98TH ST, # 1259
Practice Address - Street 2:MOUNT SINAI MEDICAL CENTER--FACULTY PRACTICE ASSOCIATES
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6574
Practice Address - Country:US
Practice Address - Phone:212-241-1657
Practice Address - Fax:212-202-4703
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2010-01-07
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Provider Licenses
StateLicense IDTaxonomies
NY202892208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery