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General NPI Number Information
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NPI Number | 1598153132
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Entity Type | Organization
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Legal Business Name | HEALTHSURE MEDICAL SERVICES
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Dates
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Enumeration Date | 01/06/2015
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Last Update Date | 01/06/2015
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Provider Practice Location Address
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Address Line | 3001 EXPRESSWAY DR N SUITE 104
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City | ISLANDIA
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State | NY
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Zip | 11749-5301
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Country | US
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Telephone | 631-435-4582
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Fax |
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Provider Business Mailing Address
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Address Line | 3001 EXPRESSWAY DR N SUITE 104
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City | ISLANDIA
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State | NY
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Zip | 11749-5301
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Country | US
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Telephone | 631-435-4582
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Fax |
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Authorized Official
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Title or Position | MD
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Name | DR. JOHN F FOLAN
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Credential | MD, FACP
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Telephone | 631-435-0110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | F306998-1
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License Number State | NY
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