Organization
WEST MIDTOWN MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL O PANIAGUA PA-C (PHYSICIAN ASSISTANT)
(212) 736-5900
Entity
Organization
Contact information
Practice address
311 W 35TH ST, NEW YORK, NY 10001-1701
(212) 736-5900
(212) 643-1441
Mailing address
4011 165TH ST, FLUSHING, NY 11358-2621
(917) 531-5896
(212) 643-1441
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
006339
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01911393
—
NY
Enumeration date
09/04/2008
Last updated
09/04/2008
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