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General NPI Number Information
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NPI Number | 1528512894
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Entity Type | Organization
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Legal Business Name | CORDIAL MEDICAL, P.C.
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Dates
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Enumeration Date | 08/04/2016
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Last Update Date | 02/21/2018
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Provider Practice Location Address
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Address Line | 100 BROADHOLLOW RD STE 106
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City | FARMINGDALE
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State | NY
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Zip | 11735-4813
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Country | US
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Telephone | 631-693-6644
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Fax | 631-693-4389
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Provider Business Mailing Address
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Address Line | 22001 JAMAICA AVE 2ND FL
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City | QUEENS VILLAGE
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State | NY
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Zip | 11428-2140
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Country | US
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Telephone | 718-878-4177
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Fax |
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Authorized Official
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Title or Position | MD, OWNER
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Name | MOHAMMUD ALAM
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Credential | MD
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Telephone | 631-693-6644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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