Provider Demographics
NPI:1902897291
Name:HIMMELSTEIN, DAVID URIUS (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:URIUS
Last Name:HIMMELSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 W 90TH ST
Mailing Address - Street 2:12A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1109
Mailing Address - Country:US
Mailing Address - Phone:212-289-0630
Mailing Address - Fax:212-722-7150
Practice Address - Street 1:255 W 90TH ST
Practice Address - Street 2:12A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1109
Practice Address - Country:US
Practice Address - Phone:212-289-0630
Practice Address - Fax:212-722-7150
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-04
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA50182207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A57209Medicare UPIN