MEDICARE: 5TOWNS MEDICAL CARE 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
1	204C00000X	Sports Medicine (Neuromusculoskeletal Medicine) Physician	206703	NY

General Provider Information

NPI Number	:	1982879326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	5TOWNS MEDICAL CARE PC

Provider Business Mailing Address
First Line	:	951 BROADWAY
Second Line	:
City	:	WOODMERE
State	:	NY
Zip	:	11598-1733
Country	:	US
Telephone Number	:	516-812-9288
Fax Number	:

Provider Business Practice Location Address
First Line	:	951 BROADWAY
Second Line	:
City	:	WOODMERE
State	:	NY
Zip	:	11598-1733
Country	:	US
Telephone Number	:	516-812-9288
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. BOGDAN D NEGREA
Credential	:	MD
Telephone Number	:	516-812-9288

Provider Enumeration Date	:	04/28/2008
Last Update Date	:	08/10/2010

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