Provider Demographics
NPI:1205167384
Name:METHUSELAH MEDICAL SERVICES PLLC
Entity type:Organization
Organization Name:METHUSELAH MEDICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:ESSIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-636-1967
Mailing Address - Street 1:25 COLIGNI AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-2605
Mailing Address - Country:US
Mailing Address - Phone:914-636-1967
Mailing Address - Fax:914-636-6083
Practice Address - Street 1:25 COLIGNI AVE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-2605
Practice Address - Country:US
Practice Address - Phone:914-636-1967
Practice Address - Fax:914-636-6083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-29
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care