Premise Health of New York Medical, P.c

NPI #1023446978 in New York, New York

Provider Information

NPI Number: 1023446978
Entity Type: Organization
Organization Name: Premise Health of New York Medical, P.c
Primary Specialty: Clinic/Center - Primary Care
Enumeration Date: Oct 30, 2013
Last Updated: Aug 15, 2022

Practice Location

Address: 1 MADISON AVE # LEVEL2B
City: New York
State: New York
ZIP Code: 10010-3603
Phone: (212) 538-7770

Authorized Official

Name: JON LEIZMAN JR., M.D.
Title: PRESIDENT
Phone: (216) 479-9063

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Primary Care — Primary Care	261QP2300X	Primary

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