Provider Demographics
NPI:1932619608
Name:NYC MEDICAL INFUSION PC
Entity Type:Organization
Organization Name:NYC MEDICAL INFUSION PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:DEUTSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-776-9090
Mailing Address - Street 1:1047 SURF AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-2810
Mailing Address - Country:US
Mailing Address - Phone:212-776-9090
Mailing Address - Fax:800-540-1852
Practice Address - Street 1:175 E 96TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-6200
Practice Address - Country:US
Practice Address - Phone:212-776-9090
Practice Address - Fax:800-540-1852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-06
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224301261QI0500X
NY0457103336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy