Organization
MADISON PHYSICIAN PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA LAZA (BILLING MANAGER)
(646) 351-0911
Entity
Organization
Contact information
Practice address
983 PARK AVE # 1D, NEW YORK, NY 10028-0808
(212) 427-8761
(212) 427-8762
Mailing address
983 PARK AVE STE 1D, NEW YORK, NY 10028-0808
(212) 427-8761
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
—
Other
Enumeration date
08/24/2018
Last updated
08/24/2018
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