Healthcare Provider Details

I. General information

NPI: 1750144416
Provider Name (Legal Business Name): MEDICAL ASSOCIATES OF LONG ISLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 02/05/2024
Certification Date: 02/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5502A BRUSH HOLLOW RD
WESTBURY NY
11590-1719
US

IV. Provider business mailing address

5502A BRUSH HOLLOW RD
WESTBURY NY
11590-1719
US

V. Phone/Fax

Practice location:
  • Phone: 516-218-6996
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BARRY D STEIN
Title or Position: OWNER
Credential: MD
Phone: 203-216-0783