Organization
BETH IZREAL MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY SEWALD M.D. (MEDICAL DIRECTOR)
(212) 256-2573
Entity
Organization
Contact information
Practice address
132 W 125TH ST, 6TH FLOOR, NEW YORK, NY 10027-4439
(212) 864-0904
(212) 865-6128
Mailing address
132 W 125TH ST, 6TH FLOOR, NEW YORK, NY 10027-4439
(212) 864-0904
(212) 865-6128
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
2511501
NY
Other
Enumeration date
02/10/2011
Last updated
02/10/2011
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