Healthcare Provider Details
I. General information
NPI: 1992249346
Provider Name (Legal Business Name): A.P. NEW YORK COMPREHENSIVE MEDICAL CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/05/2016
Last Update Date: 12/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
732 SMITHTOWN BYP SUITE 200
SMITHTOWN NY
11787-5020
US
IV. Provider business mailing address
732 SMITHTOWN BYP SUITE 200
SMITHTOWN NY
11787-5020
US
V. Phone/Fax
- Phone: 631-656-9040
- Fax: 631-656-9030
- Phone: 631-656-9040
- Fax: 631-656-9030
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ADALBERT
PILIP
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 631-656-9040