Provider Demographics
NPI:1013470277
Name:BRYANT PARK AMBULATORY MEDICAL CARE PC
Entity Type:Organization
Organization Name:BRYANT PARK AMBULATORY MEDICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FEBIN
Authorized Official - Middle Name:SURENDRAN
Authorized Official - Last Name:MELEPURA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-628-5297
Mailing Address - Street 1:36 W 44TH ST STE 914
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-8104
Mailing Address - Country:US
Mailing Address - Phone:212-621-7746
Mailing Address - Fax:646-624-2231
Practice Address - Street 1:36 W 44TH ST STE 914
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-8104
Practice Address - Country:US
Practice Address - Phone:212-621-7746
Practice Address - Fax:646-624-2231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-12
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty