Provider Demographics
NPI:1922868025
Name:FIFTH AVE ENDOMETRIOSIS MEDICAL CARE PLLC
Entity Type:Organization
Organization Name:FIFTH AVE ENDOMETRIOSIS MEDICAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TAMER
Authorized Official - Middle Name:
Authorized Official - Last Name:SECKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-988-1444
Mailing Address - Street 1:870 5TH AVE APT 1G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-4907
Mailing Address - Country:US
Mailing Address - Phone:718-915-0408
Mailing Address - Fax:
Practice Address - Street 1:870 5TH AVE APT 1G
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-4907
Practice Address - Country:US
Practice Address - Phone:718-915-0408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty