Eastside Medical Office , PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

198749 Issued in NY

Legal business name

EASTSIDE MEDICAL OFFICE , PC

Practice address

58 E 116TH St
New York, NY 10029-1147

Phone

(212) 876-9700

Fax

(212) 876-5745

NPI assigned

Dec 5, 2006

Organization subpart

No

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

Authorized official

Name

Zaw Min Oo, M.D

Title

President

Phone

(212) 876-9700

Specialties & licenses 6

Addresses

Other identifiers 5

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414108800000",
    "number": "1215095930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3117 41ST ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111033901",
            "telephone_number": "718-278-5100",
            "fax_number": "718-278-6757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 E 116TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100291147",
            "telephone_number": "212-876-9700",
            "fax_number": "212-876-5745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE MEDICAL OFFICE , PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2014-10-24",
        "status": "A",
        "authorized_official_last_name": "OO",
        "authorized_official_first_name": "ZAW",
        "authorized_official_middle_name": "MIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-876-9700",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "NY",
            "license": "214914",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "198749",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "136246",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "176228",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "205570",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "230776",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01369795",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01843681",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02678706",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02232575",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01616673",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eastside ENT PLLC
• Eastside Gynecology Services
• Eastside Kinesthetic Center
• Eastside Medical Associates, P.C.
• Eastside Medical Care PLLC
• Eastside Medical Practice, P.C.
• Eastside Medical Radiology PLLC
• Eastside Optometric, P.C.
• Eastside Oral Surgery
• Eastside Orthotics & Prosthetics Inc

• Internal Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; 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.