Organization
AVENUE MEDICAL WELLNESS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERA RAISEN MD (LEAD PHYSICIAN)
(646) 200-5750
Entity
Organization
Contact information
Practice address
535 5TH AVE RM 603, NEW YORK, NY 10017-8009
(646) 200-5750
(833) 322-1167
Mailing address
535 5TH AVE RM 603, NEW YORK, NY 10017-8009
(646) 200-5757
(833) 322-1167
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/17/2021
Last updated
12/17/2021
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