Healthcare Provider Details

I. General information

NPI: 1780048041
Provider Name (Legal Business Name): NEW FOCUS MEDICNE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2016
Last Update Date: 04/12/2016
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:
Mailing address:
  • Phone: 516-487-1902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number229594-1
License Number StateNY

VIII. Authorized Official

Name: DR. RICHARD ARONWALD
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 516-487-1902