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General NPI Number Information
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NPI Number | 1710020417
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Entity Type | Organization
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Legal Business Name | STATMD PHYSICIANS, PLLC
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 03/08/2022
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Provider Practice Location Address
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Address Line | 2090 JERICHO TPKE
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-4719
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Country | US
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Telephone | 516-352-7828
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Fax | 516-352-7827
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Provider Business Mailing Address
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Address Line | 2090 JERICHO TPKE
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-4719
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Country | US
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Telephone | 516-352-7828
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Fax | 516-352-7827
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. SAFIA HUDA
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Credential |
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Telephone | 516-352-7828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number |
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License Number State |
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