Organization
501 WEST MEDICAL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIM MYRUTH NICHOLS M.D. (MANAGING DIRECTOR)
(646) 526-3641
Entity
Organization
Contact information
Practice address
501 W 145TH ST, SUITE 3, NEW YORK, NY 10031-5132
(646) 526-3641
Mailing address
501 W 145TH ST, SUITE 3, NEW YORK, NY 10031-5132
(646) 526-3641
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
60-239556
NY
Other
Enumeration date
05/28/2006
Last updated
01/09/2008
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