| Pathways Medical Pllc | |
|
111 W 110th St New York NY 10026-4281 | |
| (212) 856-2740 | |
| (212) 537-6414 |
| Full Name | Pathways Medical Pllc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 111 W 110th St, New York, New York |
| Authorized Official Name and Position | Diego A Ponieman (OWNER) |
| Authorized Official Contact | 2128652740 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pathways Medical Pllc 111 W 110th St New York NY 10026-4281 Ph: (212) 856-2740 | Pathways Medical Pllc 111 W 110th St New York NY 10026-4281 Ph: (212) 856-2740 |
| NPI Number | 1285314609 |
|---|---|
| Provider Enumeration Date | 07/20/2023 |
| Last Update Date | 07/20/2023 |
| Certification Date | 07/20/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285314609 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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