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General NPI Number Information
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NPI Number | 1699656777
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Entity Type | Organization
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Legal Business Name | ROSLYN PRIMARY CARE, PLLC
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Dates
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Enumeration Date | 09/08/2025
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 4 MINEOLA AVE
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City | ROSLYN HEIGHTS
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State | NY
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Zip | 11577-1091
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Country | US
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Telephone | 516-277-2340
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Fax | 516-277-2342
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Provider Business Mailing Address
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Address Line | 4 MINEOLA AVE
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City | ROSLYN HEIGHTS
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State | NY
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Zip | 11577-1091
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Country | US
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Telephone | 516-277-2340
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Fax | 516-277-2342
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Authorized Official
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Title or Position | ATTENDING PHYSICIAN
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Name | NICHOLAS MORGAN WEBER
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Credential | MD, MPH
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Telephone | 516-640-6565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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