Mid Island Medical PC
Clinic/Center, Pain in East Patchogue, NY. Organization (NPI-2).
NPI number1356830954
StatusActive
Last updated in NPPESMay 9, 2018
Details
- NPI
- 1356830954
- Entity type
- Organization (NPI-2)
- Legal business name
- Mid Island Medical PC
- Organization subpart
- No
- Enumeration date
- May 9, 2018
- Last updated
- May 9, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP3300X | Clinic/Center, Pain | 234347 | NY | Yes |
Practice location
285 Sills RdEast Patchogue, NY 11772-4869
Phone 631-618-9030
Mailing address
285 Sills RdEast Patchogue, NY 11772-4869
Phone 631-618-9030
Authorized official
Musarrat Iqbal
Physician
6316189030
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