OrganizationEastside Medical Office , PcInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address58 E 116th St, New York, NY 10029-1147(212) 876-9700(718) 278-5100PECOS EnrollmentBased on the most recent information from CMS, provider Eastside Medical Office , Pc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1215095930Provider TypeOrganizationFull NameEastside Medical Office , PcSubpartNoEnumeration Date12/5/2006Last Updated10/24/2014Contact InformationPractice LocationPractice Address58 E 116th St, New York, NY 10029-1147Phone(212) 876-9700Fax(212) 876-5745Mailing LocationMailing Address3117 41st St, Astoria, NY 11103-3901Phone(718) 278-5100Fax(718) 278-6757Authorized OfficialNameOo, Zaw Min (President)Phone(212) 876-9700Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense198749New YorkCode207N00000XDescriptionDermatologyAllopathic & Osteopathic PhysiciansLicense214914New YorkCode207RC0000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense136246New YorkCode207RG0100XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense176228New YorkCode207RN0300XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense205570New YorkCode2084P0800XDescriptionPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansLicense230776New YorkProvider IdentifiersIDDescriptionIssuerID01369795DescriptionMedicaidIssuerUnlistedNew YorkID01843681DescriptionMedicaidIssuerUnlistedNew YorkID02678706DescriptionMedicaidIssuerUnlistedNew YorkID02232575DescriptionMedicaidIssuerUnlistedNew YorkID01616673DescriptionMedicaidIssuerUnlistedNew York