Plaza East Internal Medicine PC
Organization Active NPI Legal Medicine · New York, NY
NPI 1699787259 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1699787259
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Legal Medicine 173000000X
- License
- 2015162 (NY)
- Legal business name
- PLAZA EAST INTERNAL MEDICINE PC
- Practice address
- 110 E 59TH St
Suite 10a
New York, NY 10022-1304 - Phone
- (212) 750-7404
- NPI assigned
- Aug 12, 2006
- Organization subpart
- No
Authorized official
- Name
- Mindy Weiss
- Title
- Sole Proprieter
- Phone
- (212) 750-7404
Practitioners 13
-
Mindy Weiss, MD
-
Ahuva Brown, PA
-
Asima Rafiq Chaudhry, D.P.M
-
James Newell Dillard, M.D.
-
Ionica E Lazar, NP
-
Glory Mathew, FNP
-
Mary Elizabeth Stein, ANP
-
Sirisha R Tikko, MD
-
Suraj K Tikko, MD
-
Joseph S Winik, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080205000378 | NY | Part B Supplier - Clinic/Group Practice | 0941382535 |
Receives reassigned benefits from 3 practitioners Practice locations: New York, NY |
National Provider Directory
Locations
161 Madison Ave
Rm 10E
New York, NY 10016
Phone (212) 750-7404
192 Lexington Ave
Fl 2
New York, NY 10016
Phone (212) 370-1200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Legal Medicine |
173000000X | 2015162 | NY | Yes |
Addresses
Primary practice location
110 E 59TH St
Suite 10a
New York, NY 10022-1304
Mailing address
110 E 59TH St
Suite 10a
New York, NY 10022-1304
NPI Registry JSON
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1699787259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 E 59TH ST",
"address_2": "SUITE 10A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100221304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 E 59TH ST",
"address_2": "SUITE 10A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100221304",
"telephone_number": "212-750-7404"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PLAZA EAST INTERNAL MEDICINE PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-12",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "WEISS",
"authorized_official_first_name": "MINDY",
"authorized_official_title_or_position": "SOLE PROPRIETER",
"authorized_official_telephone_number": "212-750-7404"
},
"taxonomies": [
{
"code": "173000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Legal Medicine",
"state": "NY",
"license": "2015162",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.