Provider Demographics
NPI:1982933446
Name:OSTEOPATHY NEW YORK, P.C.
Entity type:Organization
Organization Name:OSTEOPATHY NEW YORK, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:212-226-6264
Mailing Address - Street 1:44 E 12TH ST
Mailing Address - Street 2:SUITE MD4
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4632
Mailing Address - Country:US
Mailing Address - Phone:212-226-6264
Mailing Address - Fax:212-388-0677
Practice Address - Street 1:44 E 12TH ST
Practice Address - Street 2:SUITE MD4
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4632
Practice Address - Country:US
Practice Address - Phone:212-226-6264
Practice Address - Fax:212-388-0677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-12
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY258525204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A100047836Medicare PIN