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General NPI Number Information
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NPI Number | 1326446204
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Entity Type | Organization
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Legal Business Name | PROMPT MEDICAL SPINE CARE
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Dates
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Enumeration Date | 12/09/2014
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Last Update Date | 12/09/2014
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Provider Practice Location Address
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Address Line | 2001 MARCUS AVE STE W170
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-2042
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Country | US
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Telephone | 516-355-9819
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Fax | 516-355-9420
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Provider Business Mailing Address
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Address Line | 2001 MARCUS AVE STE W170
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-2042
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Country | US
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Telephone | 516-355-9819
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Fax | 516-355-9420
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Authorized Official
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Title or Position | VP OF OPERATIONS
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Name | NANCY FUENTES
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Credential |
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Telephone | 516-355-9819
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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 | 2616041
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License Number State | NY
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