Organization
ONE MEDICAL GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA BENAVIDEZ (CREDENTIALING SPECIALIST)
(212) 530-2269
Entity
Organization
Contact information
Practice address
489 5TH AVE, 3RD FLOOR, NEW YORK, NY 10017-6109
(212) 530-2269
Mailing address
PO BOX 26170, SAN FRANCISCO, CA 94126-6170
(212) 530-2269
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
06/17/2009
Last updated
06/17/2009
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