Provider Demographics
NPI:1265771307
Name:UPPER EAST SIDE GYNECOLOGY PLLC
Entity type:Organization
Organization Name:UPPER EAST SIDE GYNECOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARMIT
Authorized Official - Middle Name:
Authorized Official - Last Name:ARCHIBALD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-472-6500
Mailing Address - Street 1:40 E 84TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-1115
Mailing Address - Country:US
Mailing Address - Phone:212-472-6500
Mailing Address - Fax:212-988-8737
Practice Address - Street 1:40 E 84TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-1115
Practice Address - Country:US
Practice Address - Phone:212-472-6500
Practice Address - Fax:212-988-8737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-09
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY216523207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty