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NPI Code Detail

MEDICARE: SERGIO G. SUAREZ PHYSICIAN PC

MEDICARE: SERGIO G. SUAREZ PHYSICIAN PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164729794
Entity Type Code : Organization
Provider Name (Legal Business Name) : SERGIO G. SUAREZ PHYSICIAN PC
Provider Business Mailing Address
First Line : 72 GUY LOMBARDO AVE
Second Line : SUITE 1
City : FREEPORT
State : NY
Zip : 11520-3742
Country : US
Telephone Number : 516-377-2727
Fax Number : 516-377-8088
Provider Business Practice Location Address
First Line : 72 GUY LOMBARDO AVENUE
Second Line : SUITE 1
City : FREEPORT
State : NY
Zip : 11520-3742
Country : US
Telephone Number : 516-377-2727
Fax Number : 516-377-8088
Authorized Official
Title or Position : PRESIDENT
Name : DR. SERGIO GABRIEL SUAREZ
Credential : M.D
Telephone Number : 516-377-2727
Provider Enumeration Date : 02/17/2011
Last Update Date : 02/17/2011

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Directions to “SERGIO G. SUAREZ PHYSICIAN PC ” Practice Location

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