Mott Haven Professional Medical Of New York Llc

LBN: Mott Haven Professional Medical Of New York Llc
Mott Haven Professional Medical Of New York Llc is an health care organization with primary practice located at 384 E 149Th St , Bronx NY 10455-3908. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as the primary health care specialty. Mott Haven Professional Medical Of New York Llc can be contacted via phone (718) 301-1100, or through Katsnelson, Yan via phone (847) 257-1244.

Contact Information

Primary practice address
384 E 149Th St Bronx NY 10455-3908
Phone: (718) 301-1100
Fax: (224) 246-8042
Website:
Map and Directions
Authorized official contact:
Name: Katsnelson, Yan Doctor of Medicine (MD)
Phone: (847) 257-1244

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 265506 New York

Profile Details

NPI number 1922525781
LBN Legal business name Mott Haven Professional Medical Of New York Llc
DBA Doing business as
Authorized official Katsnelson, Yan Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 23rd, 2017
Last updated Mar 26th, 2018 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922525781 NPPES
Illinois MEDICAID 036105104

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