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General NPI Number Information
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NPI Number | 1144335977
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Entity Type | Organization
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Legal Business Name | ALLIANCE FAMILY MEDICAL PRACTICE, P.C.
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 183 BROADWAY STE 308
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City | HICKSVILLE
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State | NY
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Zip | 11801-4242
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Country | US
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Telephone | 516-486-0094
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Fax | 516-486-0110
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Provider Business Mailing Address
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Address Line | 183 BROADWAY STE 308
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City | HICKSVILLE
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State | NY
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Zip | 11801-4242
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Country | US
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Telephone | 516-486-0094
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Fax | 516-486-0110
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. RUHAYNA MUKHI
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Credential | DO
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Telephone | 516-486-0094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 236676
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License Number State | NY
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