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Organization
21ST AVENUE MEDICAL PLAZA PC
NPI 1134256761
Active
Family Medicine
Quick Facts
NPI Number
1134256761
Type
Organization (NPI-2)
Status
Active
Enumeration Date
2007-02-28
Last Updated (NPPES)
2023-03-07
Primary Specialty / Taxonomy
| Taxonomy | Family Medicine |
| Taxonomy Code | 207Q00000X |
| License | 219865 NY |
Other Taxonomies
- Physical Medicine & Rehabilitation — License 208817
Data sourced live from the CMS NPPES NPI Registry (npiregistry.cms.hhs.gov) and cached locally. This is a public directory lookup, not a credentialing or verification service — confirm critical details directly with NPPES or the provider.