Organization
VILLAGE FAMILY PRACTICE
Active
Other names
village travel medicine
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY CLEMENTS MD (PRESIDENT)
(212) 477-1750
Entity
Organization
Contact information
Practice address
30 5TH AVE, 1E, NEW YORK, NY 10011-8859
(212) 477-1750
Mailing address
30 5TH AVE, 1E, NEW YORK, NY 10011-8859
(212) 477-1750
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
166998
NY
Other
Enumeration date
04/06/2012
Last updated
04/06/2012
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