# MADISON SQUARE MEDICAL

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

## Provider details

- **NPI number:** 1649656018
- **Authorized official:** SHAWN KHODADADIAN M.D. (PARTNER)
- **Authorized official phone:** (212) 533-2400

## Contact information

- **Practice address:** 51 E 25TH ST, 4TH FLOOR, SUITE 4B, NEW YORK, NY 10010-2945
- **Practice address phone:** (212) 533-2400
- **Mailing address:** 51 E 25TH ST, 4TH FLOOR, SUITE 4B, NEW YORK, NY 10010-2945
- **Mailing address phone:** (212) 533-2400

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | 236127-1 | NY | Yes |

## Other

- **Enumeration date:** 08/07/2015
- **Last updated:** 08/07/2015