Organization · NPI-2

124-15 Medical PC

Clinic/Center, Medical Specialty · Richmond Hill, NY

NPI number1811367329

StatusActive

Last updated in NPPESSep 28, 2015

Details

NPI: 1811367329
Entity type: Organization (NPI-2)
Legal business name: 124-15 Medical PC
Organization subpart: No
Enumeration date: Sep 28, 2015
Last updated: Sep 28, 2015

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
261QM2500X	Clinic/Center, Medical Specialty	–	–	Yes

Practice location

12415 Jamaica Ave
Richmond Hill, NY 11418-2649

Phone 718-480-6626

Mailing address

88 Cedar Rd
East Northport, NY 11731-4131

Phone 631-807-2477

Authorized official

Muzaffar Zai
President
6318072477

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