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General NPI Number Information
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NPI Number | 1033502703
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Entity Type | Organization
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Legal Business Name | ENDOCRINOLOGY PROFESSIONAL OF NY, PC
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Dates
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Enumeration Date | 03/05/2015
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Last Update Date | 04/30/2015
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Provider Practice Location Address
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Address Line | 804 MEACHAM AVE
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City | ELMONT
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State | NY
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Zip | 11003-4701
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Country | US
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Telephone | 516-218-2500
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Fax | 516-218-2502
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Provider Business Mailing Address
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Address Line | 26 LOCUST ST
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City | GREENVALE
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State | NY
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Zip | 11548-1110
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Country | US
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Telephone | 516-218-2500
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Fax | 516-218-2502
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FAUZIA SYED-KHAN
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Credential | M.D.
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Telephone | 718-274-0105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 228656
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License Number State | NY
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