Individual
ASA E RADIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
356 W 18TH ST, NEW YORK, NY 10011-4401
(212) 271-7200
(212) 271-7225
Mailing address
356 W 18TH ST, NEW YORK, NY 10011-4401
(212) 271-7200
(212) 271-7225
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
238905
NY
207RI0200X
Infectious Disease Physician
Primary
238905
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03137299
—
NY
Enumeration date
11/29/2006
Last updated
06/11/2019
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