| Eden Health Medical Of Va Pc | |
|
1 Liberty Plz Ste 301 New York NY 10006-1404 | |
| (917) 261-4414 | |
| Not Available |
| Full Name | Eden Health Medical Of Va Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1 Liberty Plz Ste 301, New York, New York |
| Authorized Official Name and Position | Brendan James Sullivan (PRESIDENT) |
| Authorized Official Contact | 7034637371 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eden Health Medical Of Va Pc 1 Liberty Plz Ste 301 New York NY 10006-1404 Ph: (917) 261-4414 | Eden Health Medical Of Va Pc 1 Liberty Plz Ste 301 New York NY 10006-1404 Ph: (917) 261-4414 |
| NPI Number | 1366113151 |
|---|---|
| Provider Enumeration Date | 09/22/2021 |
| Last Update Date | 04/14/2023 |
| Certification Date | 04/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366113151 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
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