Organization · NPI-2
787 Medical PC
Integrative Medicine · Glen Cove, NY
NPI number1023801842
StatusActive
Last updated in NPPESApr 1, 2026
Details
- NPI
- 1023801842
- Entity type
- Organization (NPI-2)
- Legal business name
- 787 Medical PC
- Organization subpart
- No
- Enumeration date
- May 24, 2025
- Certification date
- Apr 1, 2026
- Last updated
- Apr 1, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 202D00000X | Integrative Medicine | – | – | Yes |
| 207QA0401X | Family Medicine, Addiction Medicine | – | – | |
| 363L00000X | Nurse Practitioner | – | – | |
| 207T00000X | Neurological Surgery | – | – | |
| 208VP0000X | – | – | ||
| 207R00000X | Internal Medicine | – | – | |
| 163WP0000X | Registered Nurse, Pain Management | – | – | |
| 202K00000X | Phlebology | – | – | |
| 363A00000X | Physician Assistant | – | – | |
| 208VP0014X | Pain Medicine, Interventional Pain Medicine | – | – | |
| 2081P2900X | Physical Medicine & Rehabilitation, Pain Medicine | – | – | |
| 207QB0002X | Family Medicine, Bariatric Medicine | – | – |
Practice location
235 Forest AveGlen Cove, NY 11542-2034
Phone 718-285-7023 · Fax 516-671-6372
Mailing address
217 Old Ithaca RdHorseheads, NY 14845-1778
Phone 607-731-4644
Authorized official
Muhammad Jalaluddin
Director
2102685398
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