Provider Demographics
NPI:1518359272
Name:METROPOLIS NY MEDICAL CARE PLLC
Entity Type:Organization
Organization Name:METROPOLIS NY MEDICAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WEYMIN
Authorized Official - Middle Name:G
Authorized Official - Last Name:HAGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-468-2592
Mailing Address - Street 1:928 BROADWAY
Mailing Address - Street 2:SUITE 301
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-6008
Mailing Address - Country:US
Mailing Address - Phone:646-688-3145
Mailing Address - Fax:646-626-7555
Practice Address - Street 1:928 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-6008
Practice Address - Country:US
Practice Address - Phone:347-468-2592
Practice Address - Fax:646-626-7555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-04
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY258181207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03276928Medicaid
NYA100056217Medicare PIN