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General NPI Number Information
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NPI Number | 1154286011
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Entity Type | Organization
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Legal Business Name | NEW LEAF MEDICAL CARE PLLC
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Dates
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Enumeration Date | 12/22/2025
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 738 SMITHTOWN BYP STE 204
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City | SMITHTOWN
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State | NY
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Zip | 11787-5024
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Country | US
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Telephone | 631-413-4765
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Fax |
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Provider Business Mailing Address
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Address Line | 738 SMITHTOWN BYP STE 204
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City | SMITHTOWN
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State | NY
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Zip | 11787-5024
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Country | US
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Telephone | 631-413-4765
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | TINA MALEK
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Credential | MANAGER
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Telephone | 631-413-4765
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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