Healthcare Provider Details

I. General information

NPI: 1104848795
Provider Name (Legal Business Name): WASHINGTON MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 08/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2320 BROADWAY
ASTORIA NY
11106-4192
US

IV. Provider business mailing address

2320 BROADWAY
ASTORIA NY
11106-4192
US

V. Phone/Fax

Practice location:
  • Phone: 718-424-8660
  • Fax: 718-865-5146
Mailing address:
  • Phone: 718-424-8660
  • Fax: 718-865-5146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number237111
License Number StateNY

VIII. Authorized Official

Name: SAWEY HARHASH
Title or Position: PRESIDENT
Credential: MD
Phone: 718-424-8660