Healthcare Provider Details

I. General information

NPI: 1205493533
Provider Name (Legal Business Name): BCT MEDICAL SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2019
Last Update Date: 07/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 HILTON AVE STE 106
HEMPSTEAD NY
11550-8116
US

IV. Provider business mailing address

230 HILTON AVE STE 106
HEMPSTEAD NY
11550-8116
US

V. Phone/Fax

Practice location:
  • Phone: 516-849-4678
  • Fax:
Mailing address:
  • Phone: 516-849-4678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHERIYAN THOMAS
Title or Position: PRESIDENT
Credential: MD
Phone: 516-849-4678