Organization
EASTSIDE MEDICAL OFFICE , PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZAW MIN OO M.D (PRESIDENT)
(212) 876-9700
Entity
Organization
Contact information
Practice address
58 E 116TH ST, NEW YORK, NY 10029-1147
(212) 876-9700
(212) 876-5745
Mailing address
3117 41ST ST, ASTORIA, NY 11103-3901
(718) 278-5100
(718) 278-6757
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
214914
NY
207R00000X
Internal Medicine Physician
Primary
198749
NY
207RC0000X
Cardiovascular Disease Physician
136246
NY
207RG0100X
Gastroenterology Physician
176228
NY
207RN0300X
Nephrology Physician
205570
NY
2084P0800X
Psychiatry Physician
230776
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01369795
—
NY
05
—
01616673
—
NY
05
—
01843681
—
NY
05
—
02232575
—
NY
05
—
02678706
—
NY
Enumeration date
12/05/2006
Last updated
10/24/2014
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