67TH Street OB GYN PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

192649 Issued in NY

Legal business name

67TH STREET OB GYN PLLC

Practice address

903 Lexington Ave
Suite 1a
New York, NY 10065

Phone

(212) 249-3949

Fax

(212) 249-3916

NPI assigned

Sep 8, 2016

Organization subpart

No

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

Authorized official

Name

Daniel Roshan, MDNPI 1225025547

Title

Provider

Phone

(212) 725-0123

Specialties & licenses 1

Addresses

Tax ID family

67TH St OB-GYN2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• 67TH Street OB GYN PLLC

  • Obstetrics & Gynecology Physician
  • New York, NY
  • NPI 1306217971
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel F. Roshan, M.D.

  • Maternal & Fetal Medicine Physician
  • New York, NY
  • NPI 1225025547
  NPD (past) Authorized official

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632960000000",
    "number": "1801343736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 MIDDLE NECK RD",
            "address_2": "SUITE 8P",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110241956",
            "telephone_number": "718-253-8111",
            "fax_number": "718-253-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 LEXINGTON AVE",
            "address_2": "SUITE 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10065",
            "telephone_number": "212-249-3949",
            "fax_number": "212-249-3916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "67TH STREET OB GYN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-08",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A",
        "authorized_official_last_name": "ROSHAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "212-725-0123",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "192649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in New York, NY
• Providers in New York, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; 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.