Organization
EAST VILLAGE INTEGRATED MEDICAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARAS ODULAK DC (CEO)
(212) 260-2213
Entity
Organization
Contact information
Practice address
33 E 7TH ST, NEW YORK, NY 10003-8191
(212) 260-2213
(212) 260-2354
Mailing address
33 E 7TH ST, NEW YORK, NY 10003-8191
(212) 260-2213
(212) 260-2354
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
X006018
NY
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
264414
NY
2251S0007X
Sports Physical Therapist
264414
NY
2251S0007X
Sports Physical Therapist
—
—
Other
Enumeration date
04/18/2017
Last updated
11/13/2017
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