Jericho Medical Practice PLLC
Urology in Rockville Centre, NY. Organization (NPI-2).
NPI number1982305579
StatusActive
Last updated in NPPESMar 13, 2023
Details
- NPI
- 1982305579
- Entity type
- Organization (NPI-2)
- Legal business name
- Jericho Medical Practice PLLC
- Organization subpart
- No
- Enumeration date
- Mar 13, 2023
- Certification date
- Mar 11, 2023
- Last updated
- Mar 13, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208800000X | Urology | – | – | Yes |
Practice location
178 Sunrise Hwy # 184Rockville Centre, NY 11570-4704
Phone 877-977-1705
Mailing address
2512 148th StFlushing, NY 11354-1433
Phone 877-977-1705
Authorized official
Abul Kashem
Owner
7177167107
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