Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Coliseum Surgical & Medical PC

Organization General Practice Physician · NPI 1295890069

Coliseum Surgical & Medical PC is a General Practice Physician in New York, New York. Licensed in New York. Registered with an NPI since 2006.

Licensed in
NY
In the registry since
2006
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

30 W 60th St Ste 1H
New York, NY 10023-7906
Phone: (212) 247-6575
Fax: (212) 582-9461
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence 153732 (NY)

Record details

NPI number1295890069
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Eric Moore — Surgeon · (212) 247-6575
NPI enumeratedDecember 22, 2006
Last updated in NPPESFebruary 20, 2009
Mailing address503 Airport Executive Park, Nanuet, NY 10954-5238

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