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Individual

MANUEL R ACEVEDO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
619 W 145TH ST, NEW YORK, NY 10031-5002
(212) 234-9100
(212) 740-5163
Mailing address
619 W 145TH ST, NEW YORK, NY 10031-5002
(212) 234-9100
(212) 740-5163

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
122168
NY
208600000X
Surgery Physician
122168
NY
208D00000X
General Practice Physician
Primary
122168
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00229823
NY
Enumeration date
08/30/2006
Last updated
09/11/2025
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