Provider Demographics
| NPI: | 1871614206 |
|---|---|
| Name: | THE WESTCHESTER MEDICAL GROUP PC |
| Entity type: | Organization |
| Organization Name: | THE WESTCHESTER MEDICAL GROUP PC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | DIRECTOR OF PROFESSIONAL SERVICES |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | MAYDA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | DAVIS |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 914-681-3146 |
| Mailing Address - Street 1: | 210 WESTCHESTER AVE |
| Mailing Address - Street 2: | |
| Mailing Address - City: | WHITE PLAINS |
| Mailing Address - State: | NY |
| Mailing Address - Zip Code: | 10604-2901 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 914-681-3146 |
| Mailing Address - Fax: | 914-682-6403 |
| Practice Address - Street 1: | 1 THEALL RD |
| Practice Address - Street 2: | |
| Practice Address - City: | RYE |
| Practice Address - State: | NY |
| Practice Address - Zip Code: | 10580-1404 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 914-681-3146 |
| Practice Address - Fax: | 914-682-6403 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2007-04-03 |
| Last Update Date: | 2025-09-11 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
| No | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Multi-Specialty | |
| No | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | Group - Multi-Specialty | |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207RA0201X | Allopathic & Osteopathic Physicians | Internal Medicine | Allergy & Immunology | Group - Multi-Specialty |
| No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
| No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
| No | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | Group - Multi-Specialty |
| No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
| No | 207RN0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | Group - Multi-Specialty |
| No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
| No | 207W00000X | Allopathic & Osteopathic Physicians | Ophthalmology | Group - Multi-Specialty | |
| No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
| No | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | Group - Multi-Specialty | |
| No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| NY | W2L683 | Medicare ID - Type Unspecified |