Provider Demographics
NPI:1780047704
Name:WEST MIDTOWN MEDICAL
Entity type:Organization
Organization Name:WEST MIDTOWN MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADDICTION COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:ARROYO
Authorized Official - Suffix:
Authorized Official - Credentials:CASAC - T
Authorized Official - Phone:212-736-5900
Mailing Address - Street 1:311 W 35TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-1701
Mailing Address - Country:US
Mailing Address - Phone:212-736-5900
Mailing Address - Fax:212-643-1441
Practice Address - Street 1:311 W 35TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-1701
Practice Address - Country:US
Practice Address - Phone:212-736-5900
Practice Address - Fax:212-643-1441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-29
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY256610261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone