Provider Demographics
NPI:1891160776
Name:METROPOLIS MEDICAL PC
Entity type:Organization
Organization Name:METROPOLIS MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARIFF
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LOS SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-789-0801
Mailing Address - Street 1:5030 BROADWAY STE 816
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-1670
Mailing Address - Country:US
Mailing Address - Phone:212-567-4918
Mailing Address - Fax:
Practice Address - Street 1:111 W 110TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-4281
Practice Address - Country:US
Practice Address - Phone:212-865-2740
Practice Address - Fax:212-537-6414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-03
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty