Provider Demographics
NPI:1760148423
Name:MULTIPLE SCLEROSIS PRACTICE
Entity Type:Organization
Organization Name:MULTIPLE SCLEROSIS PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALIZA
Authorized Official - Middle Name:BITTON
Authorized Official - Last Name:BEN-ZACHARIA
Authorized Official - Suffix:
Authorized Official - Credentials:ANP, PHD
Authorized Official - Phone:646-226-2616
Mailing Address - Street 1:30 E 95TH ST APT 1A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0732
Mailing Address - Country:US
Mailing Address - Phone:646-226-2616
Mailing Address - Fax:212-426-0094
Practice Address - Street 1:30 E 95TH ST APT 1A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-0732
Practice Address - Country:US
Practice Address - Phone:646-226-2616
Practice Address - Fax:212-426-0094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02142309Medicaid