Provider Demographics
NPI:1487769782
Name:ASQUAL GETANEH M.D., P.C.
Entity type:Organization
Organization Name:ASQUAL GETANEH M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASQUAL
Authorized Official - Middle Name:
Authorized Official - Last Name:GETANEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-647-8989
Mailing Address - Street 1:213 W 136TH ST
Mailing Address - Street 2:#3
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10030-2605
Mailing Address - Country:US
Mailing Address - Phone:917-647-8989
Mailing Address - Fax:
Practice Address - Street 1:3682 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-1526
Practice Address - Country:US
Practice Address - Phone:212-926-6273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY209810261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01989202Medicaid
NY01989202Medicaid