Provider Demographics
NPI:1780011676
Name:NEW YORK CONSULTATION MEDICAL
Entity Type:Organization
Organization Name:NEW YORK CONSULTATION MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NAMGYA;
Authorized Official - Middle Name:
Authorized Official - Last Name:BHUTIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-562-6207
Mailing Address - Street 1:4526 41ST ST
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-3419
Mailing Address - Country:US
Mailing Address - Phone:212-562-6207
Mailing Address - Fax:718-766-1630
Practice Address - Street 1:3016 31ST ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-2269
Practice Address - Country:US
Practice Address - Phone:212-562-6207
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-09
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2586702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03370656Medicaid