Healthcare Provider Details

I. General information

NPI: 1689629032
Provider Name (Legal Business Name): ARSENIO MEDICAL, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 02/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 ROCKAWAY TPKE
LAWRENCE NY
11559-1216
US

IV. Provider business mailing address

215 ROCKAWAY TPKE
LAWRENCE NY
11559-1216
US

V. Phone/Fax

Practice location:
  • Phone: 516-374-5024
  • Fax: 516-374-5816
Mailing address:
  • Phone: 516-374-5024
  • Fax: 516-374-5816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number StateNY

VIII. Authorized Official

Name: VINCENT STARK
Title or Position: PRACTICE MANAGER
Credential: MPA
Phone: 516-374-5024