Organization
NYCES ENDOSCOPY SURGICARE-PC
Active
Parent organization
OMNICARE PLUS
Other names
OMNICARE PLUS
Organization subpart
Yes
Provider details
NPI number
Legal business name
OMNICARE PLUS
Authorized official
DR. EVANS CREVECOEUR M.D (PHYSICIAN/CEO)
(718) 433-0044
Entity
Organization
Contact information
Practice address
154 W 127TH ST, NEW YORK, NY 10027-3739
(718) 433-0044
(718) 433-4644
Mailing address
PO BOX 30037, ELMONT, NY 11003-0037
(718) 433-0044
(718) 433-0046
Taxonomy
Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
Primary
177953-2
NY
Other
Enumeration date
03/13/2015
Last updated
03/13/2015
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