Provider Demographics
NPI:1194250746
Name:GOTHAM REGISTRY, INC.
Entity type:Organization
Organization Name:GOTHAM REGISTRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:VITALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-477-3600
Mailing Address - Street 1:90 BROAD ST - SUITE 1201
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10004-2837
Mailing Address - Country:US
Mailing Address - Phone:212-477-3600
Mailing Address - Fax:212-405-2380
Practice Address - Street 1:90 BROAD ST - SUITE 1201
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-2837
Practice Address - Country:US
Practice Address - Phone:212-477-3600
Practice Address - Fax:212-405-2380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-20
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health