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NPI Code Detail

MEDICARE: HILLSIDE MEDICAL ASSOC., P.C.

MEDICARE: HILLSIDE MEDICAL ASSOC., P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician181084NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15501240OTHERNYGROUP HEALTH INC.

General Provider Information

NPI Number : 1235241118
Entity Type Code : Organization
Provider Name (Legal Business Name) : HILLSIDE MEDICAL ASSOC., P.C.
Provider Business Mailing Address
First Line : 915 HILLSIDE AVE
Second Line :
City : NEW HYDE PARK
State : NY
Zip : 11040-2529
Country : US
Telephone Number : 516-437-9660
Fax Number : 516-328-9355
Provider Business Practice Location Address
First Line : 915 HILLSIDE AVE
Second Line :
City : NEW HYDE PARK
State : NY
Zip : 11040-2529
Country : US
Telephone Number : 516-437-9660
Fax Number : 516-328-9355
Authorized Official
Title or Position : VICE PRESIDENT
Name : DR. SUSAN E MIRKINSON
Credential : MD.
Telephone Number : 516-437-9660
Provider Enumeration Date : 08/31/2006
Last Update Date : 03/20/2008

Similar Medicare Providers

1356392427 — DR. WILBERT B MANIEGO MD
Practice Location Address:
915 HILLSIDE AVE
NEW HYDE PARK, NY
11040-2529
Practice Phone: 718-343-7600
Practice Fax: 718-343-7603
1245282136 — DR. THOMAS P MATHEW MD
Practice Location Address:
915 HILLSIDE AVE
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1215049309 — MRS. ROSE CASSIDY N.P.
Practice Location Address:
915 HILLSIDE AVE
NEW HYDE PARK, NY
11040-2529
Practice Phone: 516-437-9660
Practice Fax: 516-328-9355
1982706446 — DR. ALAN R SANDBERG MD
Practice Location Address:
915 HILLSIDE AVE
NEW HYDE PARK, NY
11040-2529
Practice Phone: 347-236-3163
Practice Fax:
1134335946 — PREETI MEHTA MD
Practice Location Address:
915 HILLSIDE AVE
NEW HYDE PARK, NY
11040-2529
Practice Phone: 718-480-6000
Practice Fax: 347-236-3163
1215119896 — DR. UMA GAVARASANA M.D.
Practice Location Address:
915 HILLSIDE AVE
NEW HYDE PARK, NY
11040-2529
Practice Phone: 516-437-9660
Practice Fax: 516-328-9355

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