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Organization
NIGHTWATER HEALTH OF NEW YORK, PC
Active
Organization
NIGHTWATER HEALTH OF NEW YORK, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL IKEMIRE MD (CEO)
(504) 717-3050
Entity
Organization
Contact information
Practice address
501 5TH AVE RM 1203, NEW YORK, NY 10017-7872
(917) 620-2633
(504) 617-6371
Mailing address
1 BLACKFORD DR, EXETER, NH 03833-4623
(504) 717-3050
(504) 617-6371
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
320401-01
NY BOARD OF MEDICINE
NY
Enumeration date
12/01/2022
Last updated
01/11/2023
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