Memorial Clinical Genetics Group
Organization Active NPI Gynecology Physician · New York, NY
NPI 1851344337 · NPPES record last updated Apr 13, 2008
Key facts
- NPI
- 1851344337
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Gynecology Physician 207VG0400X
- Legal business name
- MEMORIAL CLINICAL GENETICS GROUP
- Practice address
- 1275 York Ave
New York, NY 10021-6007 - Phone
- (212) 639-2000
- NPI assigned
- May 18, 2006
- Organization subpart
- No
Authorized official
- Name
- Salvatore M Andreozzi
- Title
- Associate Director
- Phone
- (646) 227-3751
Practitioners 13
-
Maria Carlo, MD
-
Chimene Kesserwan, M.D.
-
Alicia Latham, MD
-
Ying Liu, MD, MPH
-
Yonina R Murciano-Goroff, MD, DPHIL
-
Kenneth Offit, MD
-
Robert Sidlow, M.D.
-
Zsofia K Stadler, M.D.
-
Mark E Robson, MD
-
Lisania Iris Milli, PHD, WHNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060508000513 | NY | Part B Supplier - Clinic/Group Practice | 6103837075 |
Receives reassigned benefits from 12 practitioners Practice locations: New York, NY |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician |
207VG0400X | Yes |
Addresses
Primary practice location
1275 York Ave
New York, NY 10021-6007
Mailing address
633 3Rd Ave
Box 3
New York, NY 10017-6706
NPI Registry JSON
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1208044800000",
"number": "1851344337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "633 3RD AVE",
"address_2": "BOX 3",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100176706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1275 YORK AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100216007",
"telephone_number": "212-639-2000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEMORIAL CLINICAL GENETICS GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-18",
"last_updated": "2008-04-13",
"status": "A",
"authorized_official_last_name": "ANDREOZZI",
"authorized_official_first_name": "SALVATORE",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "ASSOCIATE DIRECTOR",
"authorized_official_telephone_number": "646-227-3751"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
- Amaar Memon
- Sehrish Memon
- Shazia Memon
- Memorial Anesthesiology Group
- Memorial Cardiopulmonary Group
- Memorial Clinical Immunology Group
- Memorial Clinical Nutrition Group
- Memorial Clinical Physiology Group
- Memorial Critical Care Group
- Memorial Dermatology Group
All providers in New York, NY · Gynecology Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2008. 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.