Medredefined LLC
Internal Medicine in Northport, NY. Organization (NPI-2).
NPI number1235982000
StatusActive
Last updated in NPPESMay 3, 2024
Details
- NPI
- 1235982000
- Entity type
- Organization (NPI-2)
- Legal business name
- Medredefined LLC
- Organization subpart
- No
- Enumeration date
- Apr 10, 2024
- Certification date
- May 3, 2024
- Last updated
- May 3, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
| 261QU0200X | Clinic/Center, Urgent Care | – | – |
Practice location
345 Waterside RdNorthport, NY 11768-1237
Phone 631-857-4439
Mailing address
240 Main St Unit 225Northport, NY 11768-5010
Phone 832-768-0726
Authorized official
Manila Jindal
Owner
8327680726
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