Healthcare Provider Details

I. General information

NPI: 1649604661
Provider Name (Legal Business Name): V-MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2013
Last Update Date: 03/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1069 HEMPSTEAD TPKE SUITE 4
FRANKLIN SQ NY
11010-2631
US

IV. Provider business mailing address

1069 HEMPSTEAD TPKE SUITE 4
FRANKLIN SQ NY
11010-2631
US

V. Phone/Fax

Practice location:
  • Phone: 516-586-6087
  • Fax: 631-792-7011
Mailing address:
  • Phone: 516-586-6087
  • Fax: 631-792-7011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number215852
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number242798
License Number StateNY

VIII. Authorized Official

Name: CHARLES HINZ
Title or Position: PHYSICIAN
Credential: D.O.
Phone: 516-586-6087