Upper Eastside Internal Medicine

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

184535-1 Issued in NY

Legal business name

UPPER EASTSIDE INTERNAL MEDICINE

Practice address

16 Liberty Square Mall
Stony Point, NY 10980-2400

Phone

(201) 723-8776

Fax

(914) 346-5176

NPI assigned

Nov 14, 2010

Organization subpart

No

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

Authorized official

Name

Leon Scrimmager, M.D.

Title

President

Phone

(914) 346-5174

Specialties & licenses 1

Addresses

Tax ID family

Upper Eastside Internal Medicine2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Upper Eastside Internal Medicine

  • Primary Care Clinic/Center
  • New York, NY
  • NPI 1821443805
  NPD tax ID

Locations

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

{
    "created_epoch": "1289692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289692800000",
    "number": "1396046843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1821",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101631821",
            "telephone_number": "201-723-8776",
            "fax_number": "914-346-5174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 LIBERTY SQUARE MALL",
            "city": "STONY POINT",
            "state": "NY",
            "postal_code": "109802400",
            "telephone_number": "201-723-8776",
            "fax_number": "914-346-5176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER EASTSIDE INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-14",
        "last_updated": "2010-11-14",
        "status": "A",
        "authorized_official_last_name": "SCRIMMAGER",
        "authorized_official_first_name": "LEON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-346-5174",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "184535-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Liza Samson Templo, PT, DPT
• Gina Tirri, BCBA
• Unoma Tuke, LPN
• Twelve 13 Productions, LLC (Preg Appetit)
• Patrick Tyler, PHYSICAL THERAPIST A
• Neil Valdez
• Vincent Joseph Vidayathil, MD
• Amy Jocelynann Vistocco, MPT
• Walgreen Co
• Walgreen Co (Rite Aid #10554)

• Internal Medicine Physician in Stony Point, NY
• Providers in Stony Point, 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 Nov 14, 2010; 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.