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Organization

SALUS MED NEW YORK PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RAYMOND MANZANO VILLONGCO M.D. (CEO)
(646) 351-6473
Entity
Organization

Contact information

Practice address
1090 AMSTERDAM AVE, SUITE 5F, NEW YORK, NY 10025-1737
(646) 409-3557
Mailing address
123 E 88TH ST APT 5A, NEW YORK, NY 10128-1185
(646) 351-6473
(646) 351-6473

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
220788
NY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
220788
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01722150
NY
Enumeration date
02/05/2007
Last updated
08/05/2008
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