Provider Demographics
NPI:1558681015
Name:PARKMED PHYSICIAN, PC
Entity Type:Organization
Organization Name:PARKMED PHYSICIAN, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLAEI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-686-6066
Mailing Address - Street 1:800 2ND AVE
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-4709
Mailing Address - Country:US
Mailing Address - Phone:212-686-6066
Mailing Address - Fax:212-779-7724
Practice Address - Street 1:800 2ND AVE
Practice Address - Street 2:6TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-4709
Practice Address - Country:US
Practice Address - Phone:212-686-6066
Practice Address - Fax:212-779-7724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-08
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY191080207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty