# NYCES ENDOSCOPY SURGICARE-PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** OMNICARE PLUS
- **Other names:** OMNICARE PLUS
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1023401163
- **Legal business name:** OMNICARE PLUS
- **Authorized official:** DR. EVANS CREVECOEUR M.D (PHYSICIAN/CEO)
- **Authorized official phone:** (718) 433-0044

## Contact information

- **Practice address:** 154 W 127TH ST, NEW YORK, NY 10027-3739
- **Practice address phone:** (718) 433-0044
- **Practice address fax:** (718) 433-4644
- **Mailing address:** PO BOX 30037, ELMONT, NY 11003-0037
- **Mailing address phone:** (718) 433-0044
- **Mailing address fax:** (718) 433-0046

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 170100000X | Ph.D. Medical Genetics | 177953-2 | NY | Yes |

## Other

- **Enumeration date:** 03/13/2015
- **Last updated:** 03/13/2015