Provider Demographics
NPI:1033153697
Name:PHYSICIAN ASSOCIATES OF NYEEI, LLC
Entity type:Organization
Organization Name:PHYSICIAN ASSOCIATES OF NYEEI, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:
Authorized Official - Last Name:MUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-979-4200
Mailing Address - Street 1:310 E 14TH ST
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003
Mailing Address - Country:US
Mailing Address - Phone:212-979-4200
Mailing Address - Fax:212-979-4315
Practice Address - Street 1:310 EAST 14TH ST.
Practice Address - Street 2:1ST FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-979-4200
Practice Address - Fax:212-979-4315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234912174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02311264Medicaid
NY7M8401Medicare ID - Type UnspecifiedUKRAINSKY
NYW38061Medicare ID - Type Unspecified
NY02311264Medicaid
NY72F011Medicare ID - Type UnspecifiedSCHANTZ
NY3X3721Medicare ID - Type UnspecifiedSALIBY
NYWUMedicare ID - Type UnspecifiedWU
NY8M1871Medicare ID - Type UnspecifiedKIM
NY7M4711Medicare ID - Type UnspecifiedPITMAN
NY34F722Medicare ID - Type UnspecifiedLINSTROM
NY92V671Medicare ID - Type UnspecifiedALEXIADES
NY05A391Medicare ID - Type UnspecifiedTEITEL,MICHAEL
NY5246N1Medicare ID - Type UnspecifiedOVCHINSKY
NY917981Medicare ID - Type UnspecifiedSOLOMON
NY6F0201Medicare ID - Type UnspecifiedHE
NY7M4711Medicare ID - Type UnspecifiedPITMAN
NY92V671Medicare ID - Type UnspecifiedALEXIADES
NY30N791Medicare ID - Type UnspecifiedGOULLER
NYWUMedicare ID - Type UnspecifiedWU
NY8M1871Medicare ID - Type UnspecifiedKIM