Provider Demographics
NPI:1144886912
Name:EAST VILLAGE PHYSICAL MEDICINE, PC
Entity type:Organization
Organization Name:EAST VILLAGE PHYSICAL MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NATALY
Authorized Official - Middle Name:
Authorized Official - Last Name:CABRAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-260-2213
Mailing Address - Street 1:33 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-8191
Mailing Address - Country:US
Mailing Address - Phone:212-260-2213
Mailing Address - Fax:212-260-2354
Practice Address - Street 1:33 E 7TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-8191
Practice Address - Country:US
Practice Address - Phone:212-260-2213
Practice Address - Fax:212-260-2354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty