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General NPI Number Information
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NPI Number | 1891609558
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Entity Type | Organization
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Legal Business Name | CONCIERGE MEDICINE OF NEW YORK PC
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Dates
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Enumeration Date | 09/30/2026
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Last Update Date | 09/30/2026
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Provider Practice Location Address
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Address Line | 3070 MIDDLE COUNTRY ROAD SUITE 1
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City | LAKE GROVE
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State | NY
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Zip | 11507
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Country | US
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Telephone | 631-247-7463
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Fax | 631-532-4911
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Provider Business Mailing Address
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Address Line | 1188 WILLIS AVE # 227
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City | ALBERTSON
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State | NY
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Zip | 11507-1229
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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 | PRESIDENT
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Name | SATHISH J SUBBAIAH
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Credential | MD
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Telephone | 631-372-5771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State | NULL
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