Healthcare Provider Details

I. General information

NPI: 1841535929
Provider Name (Legal Business Name): TRIANGE MEDICAL CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2012
Last Update Date: 11/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 EXPRESSWAY DR S 2C
MEDFORD NY
11763-2049
US

IV. Provider business mailing address

570 EXPRESSWAY DR S 2C
MEDFORD NY
11763-2049
US

V. Phone/Fax

Practice location:
  • Phone: 631-438-0355
  • Fax: 631-438-0356
Mailing address:
  • Phone: 631-438-0355
  • Fax: 631-438-0356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MUZAFFAR ZAI
Title or Position: OWNER
Credential: D.O.
Phone: 631-438-0355