Provider Demographics
NPI:1356880561
Name:EPNEVMA, LLC
Entity type:Organization
Organization Name:EPNEVMA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CTO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROTEM
Authorized Official - Middle Name:
Authorized Official - Last Name:NAFTALOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:551-265-0597
Mailing Address - Street 1:10 AMSTERDAM AVE
Mailing Address - Street 2:SUITE 801
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7464
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10 AMSTERDAM AVE
Practice Address - Street 2:SUITE 801
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7464
Practice Address - Country:US
Practice Address - Phone:551-265-0597
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty