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General NPI Number Information
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NPI Number | 1851784318
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Entity Type | Organization
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Legal Business Name | EXPRESS MEDICAL CARE MANAGEMENT CORP
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Dates
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Enumeration Date | 03/09/2015
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Last Update Date | 03/31/2021
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Provider Practice Location Address
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Address Line | 232 MERRICK RD
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City | LYNBROOK
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State | NY
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Zip | 11563-2623
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Country | US
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Telephone | 516-256-7706
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Fax | 516-256-5556
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Provider Business Mailing Address
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Address Line | 232 MERRICK RD
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City | LYNBROOK
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State | NY
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Zip | 11563
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Country | US
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Telephone | 516-256-7706
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Fax | 516-256-5556
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Authorized Official
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Title or Position | OWNER
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Name | LAMIAA ELKOULILY
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Credential |
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Telephone | 516-594-5961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 271644-1
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License Number State | NY
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