Healthcare Provider Details

I. General information

NPI: 1811931652
Provider Name (Legal Business Name): LONG ISLAND PRIMARY MEDICAL CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 05/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 FRANKLIN AVE SUITE 123
GARDEN CITY NY
11530-5806
US

IV. Provider business mailing address

520 FRANKLIN AVE SUITE 123
GARDEN CITY NY
11530-5806
US

V. Phone/Fax

Practice location:
  • Phone: 516-248-6868
  • Fax: 516-248-6841
Mailing address:
  • Phone: 516-248-6868
  • Fax: 516-248-6841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH GREENSHER
Title or Position: PHYSICIAN
Credential: MD
Phone: 516-248-6868