| Legacy Medical Pllc | |
|
19 W 34th St Suite1200 New York NY 10001-3006 | |
| (212) 924-7676 | |
| (212) 924-7676 |
| Full Name | Legacy Medical Pllc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 19 W 34th St, New York, New York |
| Authorized Official Name and Position | Madhu Boppana (OWNER) |
| Authorized Official Contact | 2129247676 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Medical Pllc 19 West 34th Street Suite1200 New York NY 10001-3006 Ph: (212) 924-7676 | Legacy Medical Pllc 19 W 34th St Suite1200 New York NY 10001-3006 Ph: (212) 924-7676 |
| NPI Number | 1659628832 |
|---|---|
| Provider Enumeration Date | 08/07/2012 |
| Last Update Date | 08/07/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659628832 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 199052-1 (New York) | Primary |
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