Organization
FIFTH AVENUE MEDICAL ASSOCIATES, LLC
Active
Organization
FIFTH AVENUE MEDICAL ASSOCIATES, LLC
Active
Other names
Beny J. Primm Medical Group, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES Y JIN M.D. (MEMBER)
(646) 898-2037
Entity
Organization
Contact information
Practice address
745 5TH AVE, SUITE 500, NEW YORK, NY 10151-0099
(646) 898-2037
Mailing address
745 5TH AVE, SUITE 500, NEW YORK, NY 10151-0099
(646) 898-2037
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
101838
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02216131
—
NY
Enumeration date
05/03/2016
Last updated
11/19/2018
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