# OBM MEDICAL MANAGEMENT INC

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

## Provider details

- **NPI number:** 1801246582
- **Authorized official:** CHANA MIRSKY (CEO)
- **Authorized official phone:** (718) 614-2384

## Contact information

- **Practice address:** 3485 E TREMONT AVE, BRONX, NY 10465-2016
- **Practice address phone:** (718) 828-1549
- **Practice address fax:** (718) 828-5029
- **Mailing address:** 4864 ARTHUR KILL RD, STATEN ISLAND, NY 10309-2650
- **Mailing address phone:** (718) 317-2300
- **Mailing address fax:** (718) 356-4130

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 302R00000X | Health Maintenance Organization | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LX0001X | Obstetrics & Gynecology Nurse Practitioner | — | NULL | — |
| 363LX0001X | Obstetrics & Gynecology Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 06/14/2016
- **Last updated:** 06/14/2021