Statue TC LLC

Primary specialty

Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X

Legal business name

STATUE TC LLC

Practice address

900 Broadway Ste 203
New York, NY 10003-1241

Phone

(212) 949-0393

Fax

(212) 949-0396

NPI assigned

Apr 14, 2020

Organization subpart

No

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

Authorized official

Name

Omar Noor, MDNPI 1124319397

Title

President

Phone

(212) 949-0393

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Omar Noor, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Somerset, NJ
  • NPI 1124319397
  NPD Authorized official

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

{
    "created_epoch": "1586822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615334400000",
    "number": "1851910319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 MADISON AVE STE 410",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100225818",
            "telephone_number": "516-972-7075",
            "fax_number": "516-407-2911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 BROADWAY STE 203",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100031241",
            "telephone_number": "212-949-0393",
            "fax_number": "212-949-0396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATUE TC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-14",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A",
        "authorized_official_last_name": "NOOR",
        "authorized_official_first_name": "OMAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-949-0393",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacquelyn S Stathis, NP
• Station Physical Therapy
• Station Physical Therapy P.C.
• Maya Jordyn Statmore, LMSW
• Ashley Beth Statter, RD
• Danielle Rosenfeld Staub, CDN
• Mallory Stauber
• Zachary Bernard Stauber, MD
• Amanda Elle Staubitz
• Cameron Noel Staubs-Friedmann, MD

• Electroneurodiagnostic Specialist/Technologist in New York, NY
• Providers in New York, NY by specialty
• Electroneurodiagnostic Specialist/Technologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.