# GRAND CENTRAL MEDICAL SERVICES PLLC

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

## Provider details

- **NPI number:** 1679404040
- **Authorized official:** MS. JADE LOR (MANAGER)
- **Authorized official phone:** (929) 389-5969

## Contact information

- **Practice address:** 315 MADISON AVE RM 201, NEW YORK, NY 10017-5438
- **Practice address phone:** (929) 551-3588
- **Mailing address:** 450 LEXINGTON AVE UNIT 586, NEW YORK, NY 10163-9618
- **Mailing address phone:** (929) 389-5969

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | — | NULL | — |
| 171100000X | Acupuncturist | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207RN0300X | Nephrology Physician | — | NULL | — |
| 207RN0300X | Nephrology Physician | — | — | — |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 05/26/2026
- **Last updated:** 05/26/2026