Provider Demographics
NPI:1801412523
Name:FIFTH AVE MEDICAL PLLC
Entity Type:Organization
Organization Name:FIFTH AVE MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIF
Authorized Official - Middle Name:
Authorized Official - Last Name:SECKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-915-0408
Mailing Address - Street 1:3 E 68TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-4901
Mailing Address - Country:US
Mailing Address - Phone:212-988-1444
Mailing Address - Fax:212-988-1755
Practice Address - Street 1:3 E 68TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-4901
Practice Address - Country:US
Practice Address - Phone:212-988-1444
Practice Address - Fax:212-988-1755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty