Healthcare Provider Details

I. General information

NPI: 1558592147
Provider Name (Legal Business Name): WILLIAM C. PADULA MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2009
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5240 MERRICK RD SUITE #2
MASSAPEQUA NY
11758-6207
US

IV. Provider business mailing address

5240 MERRICK RD SUITE #2
MASSAPEQUA NY
11758-6207
US

V. Phone/Fax

Practice location:
  • Phone: 516-798-2200
  • Fax: 516-798-3242
Mailing address:
  • Phone: 516-798-2200
  • Fax: 516-798-3242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM COSMO PADULA
Title or Position: M.D. PRESIDENT
Credential: MEDICAL DOCTOR
Phone: 631-789-2020