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Organization

61-3 MEDICAL PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CRYSTAL TOUSSAINT (ADMINISTRATIVE ASSISTANT)
(212) 362-3470
Entity
Organization

Contact information

Practice address
1041 3RD AVE, 2ND FL, NEW YORK, NY 10065-8114
(212) 362-3470
Mailing address
1041 3RD AVE, 2ND FL, NEW YORK, NY 10065-8114

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary

Other

Enumeration date
09/29/2025
Last updated
09/29/2025
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