Provider Demographics
NPI:1396922563
Name:DR. RICARDO E POU PHYSICIAN P.C.
Entity type:Organization
Organization Name:DR. RICARDO E POU PHYSICIAN P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:E
Authorized Official - Last Name:POU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-316-3276
Mailing Address - Street 1:229 W 97TH ST
Mailing Address - Street 2:SUITE 1-D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5609
Mailing Address - Country:US
Mailing Address - Phone:212-316-3276
Mailing Address - Fax:
Practice Address - Street 1:229 W 97TH ST
Practice Address - Street 2:SUITE 1-D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-5609
Practice Address - Country:US
Practice Address - Phone:212-316-3276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192097-1207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty