Healthcare Provider Details

I. General information

NPI: 1144581505
Provider Name (Legal Business Name): DEVI MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2012
Last Update Date: 06/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 STEWART AVE SUITE 262
GARDEN CITY NY
11530-4893
US

IV. Provider business mailing address

901 STEWART AVE SUITE 262
GARDEN CITY NY
11530-4893
US

V. Phone/Fax

Practice location:
  • Phone: 516-222-2727
  • Fax:
Mailing address:
  • Phone: 516-222-2727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number StateNY

VIII. Authorized Official

Name: DR. SRIDEVI BHUMI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 516-222-2727