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Organization
NY EAST SIDE SURGERY, PC
Active
Organization
NY EAST SIDE SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARRICK E. ANTELL M.D. (MEDICAL DIRECTOR)
(212) 988-4040
Entity
Organization
Contact information
Practice address
850 PARK AVE, NEW YORK, NY 10075-1845
(212) 988-4040
Mailing address
850 PARK AVE, NEW YORK, NY 10075-1845
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
CERT# 1589
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CERT# 1589
AAAASF, INC.
NY
Enumeration date
11/22/2016
Last updated
11/22/2016
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