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General NPI Number Information
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NPI Number | 1780036228
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Entity Type | Organization
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Legal Business Name | BRIARWOOD MEDICAL PRACTICE PC
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Dates
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Enumeration Date | 07/08/2016
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Last Update Date | 07/08/2016
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Provider Practice Location Address
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Address Line | 164 WEEKS DR
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City | DIX HILLS
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State | NY
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Zip | 11746-6216
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Country | US
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Telephone | 718-739-8807
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Fax |
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Provider Business Mailing Address
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Address Line | 164 WEEKS DR
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City | DIX HILLS
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State | NY
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Zip | 11746-6216
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LLOYD SOOKHU
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Credential | MD
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Telephone | 718-739-8807
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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