# PREMISE HEALTH OF NEW YORK MEDICAL, P.C

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Colgate - New York
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801776489
- **Authorized official:** JON LEIZMAN MD (PRESIDENT)
- **Authorized official phone:** (615) 468-6270

## Contact information

- **Practice address:** 300 PARK AVE FL 7, NEW YORK, NY 10022-7412
- **Practice address phone:** (212) 310-2251
- **Practice address fax:** (212) 310-2605
- **Mailing address:** 5500 MARYLAND FARMS 120, BRENTWOOD, TN 37027

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/04/2025
- **Last updated:** 09/04/2025