Organization · NPI-2

Nischal Medical Professional Corporation

Family Medicine · Mineola, NY

NPI number1346505658
StatusActive
Last updated in NPPESDec 12, 2023

Details

NPI
1346505658
Entity type
Organization (NPI-2)
Legal business name
Nischal Medical Professional Corporation
Organization subpart
No
Enumeration date
Jul 12, 2012
Certification date
Dec 12, 2023
Last updated
Dec 12, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine239532NYYes

Practice location

172 Herricks Rd
Mineola, NY 11501-2206

Phone 516-499-6963 · Fax 516-352-0740

Mailing address

1756 Aladdin Ave
New Hyde Park, NY 11040-4012

Phone 516-498-7838 · Fax 516-352-0740

Authorized official

Sanjeev Nischal
President
5164996963

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