FIFTH AVENUE MEDICAL ASSOCIATES, LLC


Address: 745 5th Ave, Suite 500, New York, NY 10151-0099
Phone: 6468982037

FIFTH AVENUE MEDICAL ASSOCIATES, LLC (NPI# 1083069439) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1083069439
Entity Type Organization
Organization Name FIFTH AVENUE MEDICAL ASSOCIATES, LLC
Other Organization Name BENY J. PRIMM MEDICAL GROUP, LLC
Practice Address 745 5th Ave
Suite 500
New York
NY 10151-0099
Practice Telephone 6468982037
Mailing Telephone 6468982037
Enumeration Date 2016-05-03
Last Update Date 2018-11-19
Authorized Official Name CHARLES Y JIN (MEMBER)
Authorized Official Telephone 6468982037
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QH0100X Clinic/Center
Specialization: Health Service
101838 NY Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
NY 02216131 05

Other Provider/Organization Names

Other Name Type Code
Beny J. Primm Medical Group, LLC Former Legal Business Name - Organization

Other Data Sources

Entity Type Entity Name Entity Address
New York State Corporations FIFTH AVENUE MEDICAL ASSOCIATES, LLC 200 Park Avenue, 17th Floor, New York, Ny 10166

Office Location

Street Address 745 5TH AVE
SUITE 500
City NEW YORK
State NY
Zip Code 10151-0099

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Taxonomy Information

Taxonomy Code 261QH0100X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Health Service

Taxonomy Definition

Definition to come...
Notes: [7/1/2006: modified title]

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Competitor

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City NEW YORK
Zip Code 10151

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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