Organization · NPI-2

125 Liberty Medical PLLC

Family Medicine · South Richmond Hill, NY

NPI number1386957546
StatusActive
Last updated in NPPESJul 19, 2010

Details

NPI
1386957546
Entity type
Organization (NPI-2)
Legal business name
125 Liberty Medical PLLC
Organization subpart
No
Enumeration date
Jul 16, 2010
Last updated
Jul 19, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine214856-1NYYes

Practice location

12507 Liberty Ave
South Richmond Hill, NY 11419-2233

Phone 718-845-8900 · Fax 718-845-0148

Mailing address

12507 Liberty Ave
South Richmond Hill, NY 11419-2233

Phone 718-845-8900 · Fax 718-845-0148

Authorized official

Muntaz Majeed
Director
7188439100

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Family Medicine providers in South Richmond Hill, NY