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General NPI Number Information
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NPI Number | 1427952167
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Entity Type | Organization
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Legal Business Name | NORTHVALE MEDICAL LLC
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Dates
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Enumeration Date | 10/06/2026
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Last Update Date | 10/06/2026
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Provider Practice Location Address
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Address Line | 47 LEXINGTON AVE
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City | BETHPAGE
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State | NY
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Zip | 11714-3107
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Country | US
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Telephone | 307-316-1096
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Fax |
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Provider Business Mailing Address
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Address Line | 447 BROADWAY FL 2
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City | NEW YORK
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State | NY
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Zip | 10013-2562
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | SHAHNILA RASUL
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Credential |
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Telephone | 307-316-1096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | NULL
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