MEDICARE: HEALTHPLEX, I.P.A., INC.

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	305R00000X	Preferred Provider Organization

General Provider Information

NPI Number	:	1437141975
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHPLEX, I.P.A., INC.

Provider Business Mailing Address
First Line	:	333 EARLE OVINGTON BLVD
Second Line	:	SUITE 300
City	:	UNIONDALE
State	:	NY
Zip	:	11553-3610
Country	:	US
Telephone Number	:	516-542-2200
Fax Number	:	516-794-3186

Provider Business Practice Location Address
First Line	:	333 EARLE OVINGTON BLVD
Second Line	:	SUITE 300
City	:	UNIONDALE
State	:	NY
Zip	:	11553-3610
Country	:	US
Telephone Number	:	516-542-2200
Fax Number	:	516-794-3186

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	DR. BRUCE H. SAFRAN
Credential	:	D.D.S.
Telephone Number	:	516-542-2230

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	08/22/2020

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