Provider Demographics
NPI:1457741159
Name:NEW YORK INTERNAL MEDICINE, PC
Entity Type:Organization
Organization Name:NEW YORK INTERNAL MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-339-7858
Mailing Address - Street 1:1752 FRANCIS LEWIS BLVD
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-3247
Mailing Address - Country:US
Mailing Address - Phone:814-339-7858
Mailing Address - Fax:814-339-6165
Practice Address - Street 1:1865 AMSTERDAM AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-1716
Practice Address - Country:US
Practice Address - Phone:212-491-0100
Practice Address - Fax:212-491-0114
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW YORK INTERNAL MEDICINE, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY267642-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG100097256Medicare PIN