Provider Demographics
NPI:1962673293
Name:FOLEY PLAZA MEDICAL, PC
Entity Type:Organization
Organization Name:FOLEY PLAZA MEDICAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:212-385-3730
Mailing Address - Street 1:325 BROADWAY STE 204
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-3661
Mailing Address - Country:US
Mailing Address - Phone:212-385-3730
Mailing Address - Fax:212-732-1570
Practice Address - Street 1:325 BROADWAY STE 204
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-3661
Practice Address - Country:US
Practice Address - Phone:212-385-3730
Practice Address - Fax:212-732-1570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY137664261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center