| Holyspirit | |
|
10 E Merrick Rd Suite 205 Valley Stream NY 11580-5800 | |
| (516) 270-6834 | |
| Not Available |
| Full Name | Holyspirit |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 10 E Merrick Rd, Valley Stream, New York |
| Authorized Official Name and Position | Agha M Raza (PHYSICIAN) |
| Authorized Official Contact | 5162706834 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Holyspirit 117 Waldorf Ave Elmont NY 11003-1522 Ph: (516) 270-3852 | Holyspirit 10 E Merrick Rd Suite 205 Valley Stream NY 11580-5800 Ph: (516) 270-6834 |
| NPI Number | 1952504979 |
|---|---|
| Provider Enumeration Date | 06/07/2007 |
| Last Update Date | 12/13/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952504979 | NPI | - | NPPES |
| 1790851939 | Other | NY | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 239302 (New York) | Primary |
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