Primary Office
All fields are required
Type of Visit
New Patient
New Pt (No Insurance / Cash payment)
established patient / new problem
Second Opinion
Follow up visit
B12 shot
Swift treatment
Post Op (within 90 days of procedure)
Video Visit
Office
Primary Office
Reason for Visit
e.g. Initial Consultation
Patient name
Firstname Lastname
Date of birth
mm/dd/yyyy
Email
email@example.com
Home phone
(555) 555-5555
Cell phone
(555) 555-5555
Requested time
Select a time below under Available Times
Office Address:
1410 Broadway STE 1102 NY NY 10018
1410 Broadway STE 1102 NY NY 10018
New and Existing patients can make appointments online.
Office Phone:
(212) 204-2455
You must select a date and time for your appointment.
Available Times
Previous Week
Next Week
Visit Length:
30 minutes
Submit Appointment Request
You will receive an email confirmation.
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Action Required: Confirm your appointment