# 67TH STREET OB GYN PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306217971
- **Authorized official:** DANIEL ROSHAN (MD)
- **Authorized official phone:** (212) 249-3949

## Contact information

- **Practice address:** 115 E 67TH ST APT 1A, NEW YORK, NY 10065-5990
- **Practice address phone:** (212) 249-3949
- **Practice address fax:** (312) 602-9799
- **Mailing address:** PO BOX 645990, CINCINNATI, OH 45264-5990
- **Mailing address phone:** (212) 249-3949
- **Mailing address fax:** (212) 249-3916

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/08/2015
- **Last updated:** 03/01/2023