Provider Demographics
NPI:1881072866
Name:MID-MANHATTAN ORAL SURGERY PC
Entity type:Organization
Organization Name:MID-MANHATTAN ORAL SURGERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:R
Authorized Official - Last Name:CALAT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:212-696-2677
Mailing Address - Street 1:36 W 44TH ST STE 600A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-8105
Mailing Address - Country:US
Mailing Address - Phone:212-696-2677
Mailing Address - Fax:
Practice Address - Street 1:36 W 44TH ST STE 600A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-8105
Practice Address - Country:US
Practice Address - Phone:212-696-2677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCERT# 5750174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5750OtherAMERICAN ASSOCIATION FOR ACCREDITATION OF AMBULATORY SURGERY FACILITIES, INC.