# PAUL F WATERS MD LLC

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

## Provider details

- **NPI number:** 1750313458
- **Authorized official:** JEANNINE RACITI MD (BILLING MANAGER)
- **Authorized official phone:** (914) 771-7335

## Contact information

- **Practice address:** 170 W 12TH ST, NEW YORK, NY 10011-8202
- **Practice address phone:** (203) 863-4341
- **Practice address fax:** (203) 863-4249
- **Mailing address:** 55 MAMARONECK RD, SCARSDALE, NY 10583-2823
- **Mailing address phone:** (203) 863-4341
- **Mailing address fax:** (203) 863-4249

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 213723 | NY | Yes |

## Other

- **Enumeration date:** 07/06/2006
- **Last updated:** 12/10/2012