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General NPI Number Information
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NPI Number | 1134831001
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Entity Type | Organization
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Legal Business Name | TRUE NORTH MEDICAL GROUP PC
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Dates
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Enumeration Date | 12/21/2022
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 775 PARK AVE STE 380
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City | HUNTINGTON
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State | NY
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Zip | 11743-7573
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Country | US
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Telephone | 631-423-4090
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Fax | 631-423-2099
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Provider Business Mailing Address
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Address Line | 379 OAKWOOD RD STE B
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-7203
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Country | US
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Telephone | 331-351-0295
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Fax | 631-350-0255
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Authorized Official
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Title or Position | SENIOR VICE PREISDENT & CFO
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Name | MRS. MICHELE L CUSACK
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Credential |
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Telephone | 516-321-6058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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