Provider Demographics
NPI:1255409801
Name:NEW CITY MEDICAL PLLC
Entity type:Organization
Organization Name:NEW CITY MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:I
Authorized Official - Last Name:LAITMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-634-9400
Mailing Address - Street 1:20 SQUADRON BLVD
Mailing Address - Street 2:STE 290
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956
Mailing Address - Country:US
Mailing Address - Phone:845-634-9400
Mailing Address - Fax:845-634-0547
Practice Address - Street 1:20 SQUADRON BLVD
Practice Address - Street 2:STE 290
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956
Practice Address - Country:US
Practice Address - Phone:845-634-9400
Practice Address - Fax:845-634-0547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00687985Medicaid
NY00687985Medicaid
NYNEOWEU1610Medicare ID - Type Unspecified