Provider Demographics
NPI:1235143074
Name:S.V. MEDICAL, PC
Entity type:Organization
Organization Name:S.V. MEDICAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CORNELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRIEGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-328-8077
Mailing Address - Street 1:174 GRAND ST
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4803
Mailing Address - Country:US
Mailing Address - Phone:914-328-8077
Mailing Address - Fax:914-328-6083
Practice Address - Street 1:340 S BROADWAY
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-2049
Practice Address - Country:US
Practice Address - Phone:914-968-5125
Practice Address - Fax:914-968-5123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY144222207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty