Organization Active NPI

Premire Physicians of New York PLLC

  • Urology Physician
  • New York, NY
National Provider Identifier
1780938852
Registry record updated Jun 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
PREMIRE PHYSICIANS OF NEW YORK PLLC
Practice address
229 E 79TH St
New York, NY 10075-0866
Phone
(212) 717-9500
Fax
(212) 717-9503
NPI assigned
Oct 29, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2013

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

Authorized official

Name
Mitchell D Terk, MD
Title
Director
Phone
(904) 309-8680

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X NY Primary

Addresses

Primary practice location

229 E 79TH St
New York, NY 10075-0866

Mailing address

3599 University Blvd S
Suite 805
Jacksonville, FL 32216-4252
Phone (904) 309-8680

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1351468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370822400000",
    "number": "1780938852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3599 UNIVERSITY BLVD S",
            "address_2": "SUITE 805",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164252",
            "telephone_number": "904-309-8680",
            "fax_number": "904-345-5841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 E 79TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750866",
            "telephone_number": "212-717-9500",
            "fax_number": "212-717-9503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIRE PHYSICIANS OF NEW YORK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-29",
        "last_updated": "2013-06-10",
        "status": "A",
        "authorized_official_last_name": "TERK",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "904-309-8680",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": "NY",
            "license": null,
            "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. Last updated by the provider on Jun 10, 2013; 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.