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General NPI Number Information
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NPI Number | 1720359094
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Entity Type | Organization
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Legal Business Name | EXCEL MEDICAL HEALTHCARE, PLLC
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Dates
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Enumeration Date | 01/19/2012
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Last Update Date | 01/19/2012
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Provider Practice Location Address
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Address Line | 2120 HEMPSTEAD TPKE 2ND FLOOR
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City | EAST MEADOW
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State | NY
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Zip | 11554-1849
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Country | US
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Telephone | 718-496-7791
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Fax | 516-665-8079
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Provider Business Mailing Address
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Address Line | PO BOX 603
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City | BALDWIN
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State | NY
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Zip | 11510-0570
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Country | US
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Telephone | 718-496-7791
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Fax | 516-665-8079
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. LATONIA MARIA WARD
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Credential | MD
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Telephone | 718-496-7791
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 207936
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License Number State | NY
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