Provider Demographics
NPI:1699099267
Name:UPTOWN OB/GYN OF NEW YORK P.C,
Entity type:Organization
Organization Name:UPTOWN OB/GYN OF NEW YORK P.C,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-288-2788
Mailing Address - Street 1:370 RIVERSIDE DR
Mailing Address - Street 2:#3C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-2179
Mailing Address - Country:US
Mailing Address - Phone:212-288-2788
Mailing Address - Fax:631-878-4280
Practice Address - Street 1:103 E 80TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0305
Practice Address - Country:US
Practice Address - Phone:212-288-2788
Practice Address - Fax:631-878-4280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY239163207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty