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General NPI Number Information
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NPI Number | 1922189547
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Entity Type | Organization
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Legal Business Name | CMC MEDICAL PC
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 225 BROADWAY ROOM 620
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City | NEW YORK
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State | NY
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Zip | 10007-3001
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Country | US
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Telephone | 212-964-9600
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Fax | 212-964-7759
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Provider Business Mailing Address
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Address Line | 10 GREENWAY
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City | OYSTER BAY
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State | NY
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Zip | 11771-4604
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Country | US
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Telephone | 212-964-9600
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Fax | 212-964-7759
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MARINA MARGOLIN
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Credential | MD
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Telephone | 212-964-9600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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