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General NPI Number Information
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NPI Number | 1477673424
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Entity Type | Organization
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Legal Business Name | CANARSIE MEDICAL CARE P.C. D.B.A BALDWIN MEDICAL
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1885 GRAND AVE
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City | NORTH BALDWIN
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State | NY
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Zip | 11510-2453
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Country | US
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Telephone | 516-623-2277
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Fax | 516-623-2525
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Provider Business Mailing Address
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Address Line | 1885 GRAND AVE
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City | NORTH BALDWIN
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State | NY
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Zip | 11510-2453
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Country | US
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Telephone | 516-623-2277
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Fax | 516-623-2525
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Authorized Official
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Title or Position | MANAGER
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Name | SYLVIA PARK
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Credential |
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Telephone | 516-623-2277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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