Healthcare Provider Details

I. General information

NPI: 1124387279
Provider Name (Legal Business Name): ASMAT MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2012
Last Update Date: 05/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 N VILLAGE AVE SUITE 107
ROCKVILLE CTR NY
11570-3761
US

IV. Provider business mailing address

165 N VILLAGE AVE SUITE 107
ROCKVILLE CTR NY
11570-3761
US

V. Phone/Fax

Practice location:
  • Phone: 516-442-4990
  • Fax:
Mailing address:
  • Phone: 516-442-4990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: ASMAT ULLAH
Title or Position: OWNER
Credential: MD
Phone: 516-442-4990