MEDICARE: SHEFLIN MEDICAL GROUP

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
1	207Q00000X	Family Medicine Physician	219347	NY

General Provider Information

NPI Number	:	1396288940
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHEFLIN MEDICAL GROUP

Provider Business Mailing Address
First Line	:	15 MUNRO BLVD
Second Line	:
City	:	VALLEY STREAM
State	:	NY
Zip	:	11581-3304
Country	:	US
Telephone Number	:	516-791-5800
Fax Number	:	516-837-3999

Provider Business Practice Location Address
First Line	:	15 MUNRO BLVD
Second Line	:
City	:	VALLEY STREAM
State	:	NY
Zip	:	11581-3304
Country	:	US
Telephone Number	:	516-791-5800
Fax Number	:	516-837-3999

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CRAIG SHEFLIN
Credential	:	D.O.
Telephone Number	:	516-791-5800

Provider Enumeration Date	:	11/30/2016
Last Update Date	:	11/30/2016

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