Provider Demographics
NPI:1619095015
Name:EAST-WEST INTEGRATIVE MEDICINE PLLC
Entity Type:Organization
Organization Name:EAST-WEST INTEGRATIVE MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EAMONN
Authorized Official - Middle Name:ADELRICH
Authorized Official - Last Name:VITT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-674-8777
Mailing Address - Street 1:30 FIFTH AVENUE
Mailing Address - Street 2:STE 1E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011
Mailing Address - Country:US
Mailing Address - Phone:212-674-8777
Mailing Address - Fax:347-287-6907
Practice Address - Street 1:30 FIFTH AVENUE
Practice Address - Street 2:STE 1E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011
Practice Address - Country:US
Practice Address - Phone:212-674-8777
Practice Address - Fax:347-287-6907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233642261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care