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General NPI Number Information
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NPI Number | 1215593611
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Entity Type | Organization
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Legal Business Name | NORTHERN MEDICAL CENTER, INC
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Dates
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Enumeration Date | 05/13/2019
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Last Update Date | 03/25/2024
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Provider Practice Location Address
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Address Line | 14 JASON PLACE SUITE 201
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City | MIDDLETOWN
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State | NY
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Zip | 10940
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Country | US
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Telephone | 630-361-6267
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Fax | 845-625-1735
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Provider Business Mailing Address
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Address Line | 14 JASON PLACE SUITE 201
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City | MIDDLETOWN
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State | NY
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Zip | 10940
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Country | US
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Telephone | 845-800-5118
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Fax | 845-625-1735
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | JINGDUAN YANG
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Credential | MD
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Telephone | 630-361-6267
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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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