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NPI Code Detail

MEDICARE: LAGRANGEVILLE MEDICAL PC

MEDICARE: LAGRANGEVILLE MEDICAL 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

General Provider Information

NPI Number : 1861153322
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAGRANGEVILLE MEDICAL PC
Provider Business Mailing Address
First Line : 71 FRANKLIN AVE
Second Line :
City : FRANKLIN SQUARE
State : NY
Zip : 11010-2523
Country : US
Telephone Number : 718-925-2974
Fax Number :
Provider Business Practice Location Address
First Line : 71 FRANKLIN AVE
Second Line :
City : FRANKLIN SQUARE
State : NY
Zip : 11010-2523
Country : US
Telephone Number : 212-404-0362
Fax Number :
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : RANA HASSAN
Credential :
Telephone Number : 347-885-9963
Provider Enumeration Date : 01/06/2022
Last Update Date : 12/11/2025

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Directions to “LAGRANGEVILLE MEDICAL PC ” Practice Location

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