Healthcare Provider Details

I. General information

NPI: 1952170011
Provider Name (Legal Business Name): PY MEDICAL SERVICES OF MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2023
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11974 EDGEHILL TERRACE RD
PRINCESS ANNE MD
21853-2105
US

IV. Provider business mailing address

6136 170TH ST APT M4
FRESH MEADOWS NY
11365-1957
US

V. Phone/Fax

Practice location:
  • Phone: 410-651-0011
  • Fax:
Mailing address:
  • Phone: 187-090-9407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PEYMAN E YOUNESI
Title or Position: OWNER
Credential: MD
Phone: 718-709-0940