Provider Demographics
NPI:1821488529
Name:NEW YORK RESOURCE MEDICINE, PLLC
Entity Type:Organization
Organization Name:NEW YORK RESOURCE MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SIREEN
Authorized Official - Middle Name:MURARI
Authorized Official - Last Name:GOPAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-794-0600
Mailing Address - Street 1:2008 EASTCHESTER RD
Mailing Address - Street 2:2ND LEVEL
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2252
Mailing Address - Country:US
Mailing Address - Phone:718-794-0600
Mailing Address - Fax:718-794-9899
Practice Address - Street 1:2008 EASTCHESTER RD
Practice Address - Street 2:2ND LEVEL
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2252
Practice Address - Country:US
Practice Address - Phone:718-794-0600
Practice Address - Fax:718-794-9899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-02
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY201895174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty