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General NPI Number Information
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NPI Number | 1457963241
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Entity Type | Organization
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Legal Business Name | MEDICAL SERVICES OF UNIONDALE, PC
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Dates
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Enumeration Date | 08/21/2020
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Last Update Date | 07/08/2022
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Provider Practice Location Address
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Address Line | 106 CHARLES LINDBERGH BLVD STE B
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City | UNIONDALE
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State | NY
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Zip | 11553-3632
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Country | US
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Telephone | 516-248-3737
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Fax | 866-540-1163
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Provider Business Mailing Address
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Address Line | 106 CHARLES LINDBERGH BLVD STE B
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City | UNIONDALE
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State | NY
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Zip | 11553-3632
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Country | US
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Telephone | 516-248-3737
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Fax | 866-540-1163
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Authorized Official
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Title or Position | SENIOR VICE PRESIDENT & CFO
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Name | MRS. MICHELE L CUSACK
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Credential |
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Telephone | 516-321-6058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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