# BACK AND BODY MEDICAL CARE, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** dba Back and Body Medical
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306021274
- **Authorized official:** DR. SHAN SIVENDRA M.D. (PRESIDENT)
- **Authorized official phone:** (212) 371-2000

## Contact information

- **Practice address:** 133 E 58TH ST, SUITE 708, NEW YORK, NY 10022-1236
- **Practice address phone:** (212) 371-2000
- **Practice address fax:** (212) 371-2250
- **Mailing address:** 133 E 58TH ST, SUITE 708, NEW YORK, NY 10022-1236
- **Mailing address phone:** (212) 371-2000
- **Mailing address fax:** (212) 371-2250

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | 245922-1 | NY | Yes |

## Other

- **Enumeration date:** 01/09/2008
- **Last updated:** 11/15/2010