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General NPI Number Information
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NPI Number | 1124487087
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Entity Type | Organization
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Legal Business Name | LARCHMONT FAMILY MEDICINE, PLLC
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Dates
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Enumeration Date | 02/19/2016
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Last Update Date | 02/19/2016
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Provider Practice Location Address
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Address Line | 1890 PALMER AVE SUITE 304
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City | LARCHMONT
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State | NY
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Zip | 10538-3059
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Country | US
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Telephone | 914-834-9606
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Fax | 914-834-0648
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Provider Business Mailing Address
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Address Line | 1890 PALMER AVE SUITE 304
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City | LARCHMONT
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State | NY
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Zip | 10538-3059
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Country | US
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Telephone | 914-834-9606
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Fax | 914-834-0648
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Authorized Official
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Title or Position | OWNER
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Name | PHILIP HEINEGG
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Credential | M.D.
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Telephone | 914-834-9606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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