Provider Demographics
NPI:1558458414
Name:MATTHEW H. ORNSTEIN, MD, PC
Entity Type:Organization
Organization Name:MATTHEW H. ORNSTEIN, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:H
Authorized Official - Last Name:ORNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-722-7157
Mailing Address - Street 1:65 E 96TH ST
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0730
Mailing Address - Country:US
Mailing Address - Phone:212-722-7157
Mailing Address - Fax:212-722-7159
Practice Address - Street 1:65 E 96TH ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-0730
Practice Address - Country:US
Practice Address - Phone:212-722-7157
Practice Address - Fax:212-722-7159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179957-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01415127Medicaid
NYNP656OtherOXFORD HEALTH PLANS
NYF53156Medicare UPIN
NY01415127Medicaid