Coliseum Surgical & Medical PC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

153732 Issued in NY

Legal business name

COLISEUM SURGICAL & MEDICAL PC

Practice address

30 W 60TH St
Suite 1H
New York, NY 10023-7906

Phone

(212) 247-6575

Fax

(212) 582-9461

NPI assigned

Dec 22, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Eric Moore, MD

Title

Surgeon

Phone

(212) 247-6575

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235088000000",
    "number": "1295890069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 AIRPORT EXECUTIVE PARK",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109545238",
            "telephone_number": "845-426-6864",
            "fax_number": "845-356-5312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W 60TH ST",
            "address_2": "SUITE 1H",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237906",
            "telephone_number": "212-247-6575",
            "fax_number": "212-582-9461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLISEUM SURGICAL & MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2009-02-20",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "SURGEON",
        "authorized_official_telephone_number": "212-247-6575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "NY",
            "license": "153732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerlyne Colin, LMSW
• Michael Colin, MD
• Michael Joel Colin
• Suzanne Marie Louise Colin, PH.D.
• Coliseum Dental East, PLLC
• Andrew Colitz, PH.D.
• Raymond Harold Coll, MD
• Sofia Coll, PSYD
• Collab Care Therapy
• Collaborative for Better Urban Health, LLC

• General Practice Physician in New York, NY
• Providers in New York, NY by specialty
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2009; 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.