Provider Demographics
NPI:1487898052
Name:ACUMED MEDICAL CARE PLLC
Entity type:Organization
Organization Name:ACUMED MEDICAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YURY
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:KREMENTSOV M.D.
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-888-8877
Mailing Address - Street 1:150 EAST 56TH ST
Mailing Address - Street 2:#1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022
Mailing Address - Country:US
Mailing Address - Phone:212-888-8877
Mailing Address - Fax:212-888-0495
Practice Address - Street 1:150 EAST 56TH ST
Practice Address - Street 2:#1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022
Practice Address - Country:US
Practice Address - Phone:212-888-8877
Practice Address - Fax:212-888-0495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-28
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCERTIFICATE#00384171100000X
NYA150827208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty