Provider Demographics
NPI:1932095734
Name:NEW YORK MED CENTER LLC
Entity type:Organization
Organization Name:NEW YORK MED CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:MANNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-961-4265
Mailing Address - Street 1:845 ROUTE 5 AND 20
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:NY
Mailing Address - Zip Code:14081-9706
Mailing Address - Country:US
Mailing Address - Phone:716-961-7457
Mailing Address - Fax:716-970-7859
Practice Address - Street 1:845 ROUTE 5 AND 20
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:NY
Practice Address - Zip Code:14081-9706
Practice Address - Country:US
Practice Address - Phone:716-961-7457
Practice Address - Fax:716-970-7859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital