Healthcare Provider Details

I. General information

NPI: 1679308589
Provider Name (Legal Business Name): MEGALLY MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2024
Last Update Date: 09/03/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N VILLAGE AVE STE 300
ROCKVILLE CENTRE NY
11570-2300
US

IV. Provider business mailing address

200 N VILLAGE AVE STE 300
ROCKVILLE CENTRE NY
11570-2300
US

V. Phone/Fax

Practice location:
  • Phone: 516-536-8151
  • Fax:
Mailing address:
  • Phone: 516-536-8151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. MELANIE HEY
Title or Position: AUTHORIZED OFFICER
Credential:
Phone: 516-536-8151