Nyc Madison Avenue Medical PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

NYC MADISON AVENUE MEDICAL PC

Practice address

290 Madison Ave FL 6
New York, NY 10017-6306

Phone

(914) 376-6100

Fax

(914) 470-5056

NPI assigned

May 18, 2015

Organization subpart

No

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

Authorized official

Name

Muhammad Mirza, MD

Title

Medical Director

Phone

(914) 376-6100

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1431907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431907200000",
    "number": "1437537834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 MADISON AVE FL 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176306",
            "telephone_number": "914-376-6100",
            "fax_number": "914-470-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 MADISON AVE FL 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176306",
            "telephone_number": "914-376-6100",
            "fax_number": "914-470-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYC MADISON AVENUE MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-18",
        "last_updated": "2015-05-18",
        "status": "A",
        "authorized_official_last_name": "MIRZA",
        "authorized_official_first_name": "MUHAMMAD",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "914-376-6100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 May 18, 2015; 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.