Provider Demographics
NPI:1730441791
Name:E & A MEDICAL SOLUTIONS LLC
Entity type:Organization
Organization Name:E & A MEDICAL SOLUTIONS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MBA
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARAKSYA
Authorized Official - Middle Name:
Authorized Official - Last Name:GEVORGYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-241-1312
Mailing Address - Street 1:253 E 142ND ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-5906
Mailing Address - Country:US
Mailing Address - Phone:718-306-6220
Mailing Address - Fax:347-252-6261
Practice Address - Street 1:253 E 142ND ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5906
Practice Address - Country:US
Practice Address - Phone:718-306-6220
Practice Address - Fax:347-252-6261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-14
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03539604Medicaid