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General NPI Number Information
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NPI Number | 1205164621
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Entity Type | Organization
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Legal Business Name | NEPONSIT MEDICAL PC
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Dates
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Enumeration Date | 11/23/2009
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Last Update Date | 10/05/2010
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Provider Practice Location Address
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Address Line | 714 BEACH 20TH ST
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691-3502
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Country | US
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Telephone | 718-327-7457
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Fax | 718-327-7539
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Provider Business Mailing Address
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Address Line | 714 BEACH 20TH ST
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691-3502
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Country | US
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Telephone | 718-327-7457
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Fax | 718-327-7539
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Authorized Official
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Title or Position | OWNER
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Name | SHOAHANAH KAHN
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Credential | MD
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Telephone | 718-327-7457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | NY
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Taxonomy #2
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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 | NY
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | NY
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Taxonomy #4
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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 | NY
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