Organization Active NPI

Greater New York Health Medical PC

  • Primary Care Clinic/Center
  • New York, NY
National Provider Identifier
1790513810
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
GREATER NEW YORK HEALTH MEDICAL PC
Practice address
169 Madison Ave Ste 11270
New York, NY 10016-5101
Phone
(212) 812-2232
Fax
(212) 812-2232
NPI assigned
Jul 22, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Authorized official

Name
Todd Peterson
Title
Office Manager
Phone
(630) 822-8244

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

169 Madison Ave Ste 11270
New York, NY 10016-5101

Mailing address

169 Madison Ave Ste 11270
New York, NY 10016-5101
Phone (212) 812-2232

National Provider Directory

National Provider Directory

Locations

169 Madison Ave
Ste 11270
New York, NY 10016
Phone (212) 812-2232

NPI Registry JSON

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1790513810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 MADISON AVE STE 11270",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165101",
            "telephone_number": "212-812-2232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 MADISON AVE STE 11270",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165101",
            "telephone_number": "212-812-2232",
            "fax_number": "212-812-2232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER NEW YORK HEALTH MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "630-822-8244"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "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 Jul 22, 2024; 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.