| Charles A. Mitgang, M.d. P.c. | |
|
371 Merrick Rd Suite 302 Rockville Centre NY 11570-5359 | |
| (516) 678-5555 | |
| (516) 678-9128 |
| Full Name | Charles A. Mitgang, M.d. P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 371 Merrick Rd, Rockville Centre, New York |
| Authorized Official Name and Position | Charles Mitgang (PRESIDENT) |
| Authorized Official Contact | 5166785555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles A. Mitgang, M.d. P.c. 371 Merrick Rd Suite 302 Rockville Centre NY 11570-5359 Ph: (516) 678-5555 | Charles A. Mitgang, M.d. P.c. 371 Merrick Rd Suite 302 Rockville Centre NY 11570-5359 Ph: (516) 678-5555 |
| NPI Number | 1104945179 |
|---|---|
| Provider Enumeration Date | 03/28/2007 |
| Last Update Date | 12/01/2009 |
| Medicare PECOS PAC ID | 6709948417 |
|---|---|
| Medicare Enrollment ID | O20081215000115 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104945179 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 127551 (New York) | Primary |
| Provider Name | Farid Shahkoohi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124024336 PECOS PAC ID: 1658316773 Enrollment ID: I20050620001001 |
| Provider Name | Charles A Mitgang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114923315 PECOS PAC ID: 7618038324 Enrollment ID: I20081212000165 |
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