# MID MANHATTAN MEDICAL, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Park Avenue Trauma Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710370358
- **Authorized official:** DR. GIDEON HEDRYCH M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (718) 625-9911

## Contact information

- **Practice address:** 100 LIVINGSTON ST, SUITE 2, BROOKLYN, NY 11201-5127
- **Practice address phone:** (718) 625-9911
- **Practice address fax:** (718) 625-9517
- **Mailing address:** 100 LIVINGSTON ST, SUITE 2, BROOKLYN, NY 11201-5127
- **Mailing address phone:** (718) 625-9911
- **Mailing address fax:** (718) 625-9517

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 207PS0010X | Sports Medicine (Emergency Medicine) Physician | — | NULL | Yes |
| 207PS0010X | Sports Medicine (Emergency Medicine) Physician | — | — | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | — |
| 207X00000X | Orthopaedic Surgery Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 2084N0400X | Neurology Physician | — | NULL | — |
| 2084N0400X | Neurology Physician | — | — | — |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | NULL | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 03/06/2015
- **Last updated:** 03/06/2015