Healthcare Provider Details

I. General information

NPI: 1801599659
Provider Name (Legal Business Name): NAMASTE MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 04/24/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1726 VETERANS MEMORIAL HWY
ISLANDIA NY
11749-1512
US

IV. Provider business mailing address

34 HEMPSTEAD TPKE
FARMINGDALE NY
11735-2034
US

V. Phone/Fax

Practice location:
  • Phone: 516-755-5855
  • Fax:
Mailing address:
  • Phone: 167-555-8555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK SCHWARTZ
Title or Position: OWNER
Credential: DO
Phone: 516-755-5855