NPIMap

Organization Active NPI

Premise Health of New York Medical, P.C

Doing business as Credit Suisse Health Center

  • Primary Care Clinic/Center
  • New York, NY
National Provider Identifier
1023446978
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PREMISE HEALTH OF NEW YORK MEDICAL, P.C
Doing business as
Credit Suisse Health Center
Practice address
1 Madison Ave # Level2B
New York, NY 10010-3603
Phone
(212) 538-7770
Fax
(212) 538-7755
NPI assigned
Oct 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jon Leizman Jr., M.D.
Title
President
Phone
(216) 479-9063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1 Madison Ave # Level2B
New York, NY 10010-3603

Mailing address

5500 Maryland Way
Brentwood, TN 37027-4948
Phone (212) 538-7770

Other names 1

  • Credit Suisse Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Premise Health of New York Medical PC37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

Locations

1 Madison Ave
#2B
New York, NY 10010
Phone (212) 538-7770

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660521600000",
    "number": "1023446978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274948",
            "telephone_number": "212-538-7770",
            "fax_number": "212-538-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MADISON AVE # LEVEL2B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100103603",
            "telephone_number": "212-538-7770",
            "fax_number": "212-538-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF NEW YORK MEDICAL, P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-30",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A",
        "authorized_official_last_name": "LEIZMAN",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-479-9063",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Credit Suisse Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Credit Suisse Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.