Provider Demographics
NPI:1013334234
Name:MIDTOWN MEDICAL SOLUTIONS PC
Entity Type:Organization
Organization Name:MIDTOWN MEDICAL SOLUTIONS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MICHEAL
Authorized Official - Last Name:VENTRUDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-490-3800
Mailing Address - Street 1:144 E 44TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-4008
Mailing Address - Country:US
Mailing Address - Phone:212-490-3800
Mailing Address - Fax:212-490-6657
Practice Address - Street 1:144 E 44TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-4008
Practice Address - Country:US
Practice Address - Phone:212-490-3800
Practice Address - Fax:212-490-6657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-26
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242798208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY958221Medicare PIN