Healthcare Provider Details

I. General information

NPI: 1932273455
Provider Name (Legal Business Name): MESIBOV AND ALTMAN LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 UNDERHILL BLVD SUITE 101
SYOSSET NY
11791-3418
US

IV. Provider business mailing address

50 UNDERHILL BLVD SUITE 101
SYOSSET NY
11791-3418
US

V. Phone/Fax

Practice location:
  • Phone: 516-921-2122
  • Fax: 516-921-0670
Mailing address:
  • Phone: 516-921-2122
  • Fax: 516-921-0670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. STEWART ALTMAN
Title or Position: OWNER PARTNER
Credential:
Phone: 516-921-2122