Provider Demographics
NPI:1922651629
Name:NYCS MID TOWN MEDICAL SERVICES PC
Entity Type:Organization
Organization Name:NYCS MID TOWN MEDICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AZIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-699-2525
Mailing Address - Street 1:123 N SEA ROAD
Mailing Address - Street 2:P.O BOX 1388
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11968
Mailing Address - Country:US
Mailing Address - Phone:212-906-9111
Mailing Address - Fax:212-906-9100
Practice Address - Street 1:123 N SEA RD
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11968-2003
Practice Address - Country:US
Practice Address - Phone:212-906-9111
Practice Address - Fax:212-906-9100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-22
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty