| Bethpage Medical Wellness Pc | |
|
4250 Hempstead Tpke Suite 19 Bethpage NY 11714-5711 | |
| (516) 597-4433 | |
| Not Available |
| Full Name | Bethpage Medical Wellness Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4250 Hempstead Tpke, Bethpage, New York |
| Authorized Official Name and Position | Bita Ashourzadeh (OWNER) |
| Authorized Official Contact | 5166105081 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bethpage Medical Wellness Pc 4250 Hemstead Turnpike Suite 19 Bethpage NY 11714-5707 Ph: (516) 597-4433 | Bethpage Medical Wellness Pc 4250 Hempstead Tpke Suite 19 Bethpage NY 11714-5711 Ph: (516) 597-4433 |
| NPI Number | 1578813838 |
|---|---|
| Provider Enumeration Date | 09/14/2012 |
| Last Update Date | 06/27/2024 |
| Medicare PECOS PAC ID | 9234381633 |
|---|---|
| Medicare Enrollment ID | O20121211000496 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578813838 | NPI | - | NPPES |
| 02227989 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 221358 (New York) | Primary |
| Provider Name | Bita Ashourzadeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790720027 PECOS PAC ID: 7113900309 Enrollment ID: I20040609000820 |
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