Healthcare Provider Details

I. General information

NPI: 1831370113
Provider Name (Legal Business Name): HYPERBARIC MEDICINE OF NEWYORK,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2007
Last Update Date: 11/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 COMMUNITY DR
GREAT NECK NY
11021-5504
US

IV. Provider business mailing address

290 COMMUNITY DR
GREAT NECK NY
11021-5504
US

V. Phone/Fax

Practice location:
  • Phone: 516-487-1902
  • Fax: 516-487-4156
Mailing address:
  • Phone: 516-487-1902
  • Fax: 516-487-4156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RACHEL MIZRAHI
Title or Position: MANAGER
Credential:
Phone: 516-626-6600