Mid Manhattan Medical, P.C.

Primary specialty

Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X

Legal business name

MID MANHATTAN MEDICAL, P.C.

Practice address

100 Livingston St
Suite 2
Brooklyn, NY 11201-5127

Phone

(718) 625-9911

Fax

(718) 625-9517

NPI assigned

Mar 6, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Gideon Hedrych, M.D.

Title

Medical Director

Phone

(718) 625-9911

Specialties & licenses 7

Addresses

Other names 1

• Park Avenue Trauma Associates Doing business as

Tax ID family

Mid Manhattan Medical PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Mid-Manhattan Medical, P.C.

  • Specialist
  • New York, NY
  • NPI 1598093494
  NPD tax ID
• Park Avenue Trauma Associates

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1154713725
  NPD tax ID

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

{
    "created_epoch": "1425600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425600000000",
    "number": "1710370358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 LIVINGSTON ST",
            "address_2": "SUITE 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015127",
            "telephone_number": "718-625-9911",
            "fax_number": "718-625-9517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LIVINGSTON ST",
            "address_2": "SUITE 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015127",
            "telephone_number": "718-625-9911",
            "fax_number": "718-625-9517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID MANHATTAN MEDICAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-06",
        "last_updated": "2015-03-06",
        "status": "A",
        "authorized_official_last_name": "HEDRYCH",
        "authorized_official_first_name": "GIDEON",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-625-9911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207PS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Avenue Trauma Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shira Michelson, LMSW
• Yitzchok Michelson
• Samuel R Mickens, RN
• George Mickles III
• Sheri Micklin
• Midas Diagnostic Solutions Inc
• Kendra Midcap
• Midcity Dental Group
• Middle Way Psychotherapy, LCSW P.C.
• Andrea Middleton

• Sports Medicine (Emergency Medicine) Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Sports Medicine (Emergency Medicine) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.