Provider Demographics
NPI:1912219932
Name:GOTHAM PER DIEM, INC
Entity Type:Organization
Organization Name:GOTHAM PER DIEM, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:VITALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-477-6100
Mailing Address - Street 1:90 BROAD ST - SUITE 1201
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10004-2837
Mailing Address - Country:US
Mailing Address - Phone:212-477-6100
Mailing Address - Fax:
Practice Address - Street 1:90 BROAD ST - SUITE 1201
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-2837
Practice Address - Country:US
Practice Address - Phone:212-477-6100
Practice Address - Fax:212-405-2395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-07
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6881237251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care