Healthstar Medical Pc | |
747 Montauk Highway West Islip NY 11795 | |
(631) 321-1286 | |
(631) 321-1379 |
Full Name | Healthstar Medical Pc |
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Speciality | Family Medicine |
Location | 747 Montauk Highway, West Islip, New York |
Authorized Official Name and Position | Lada Osipova (PRESIDENT) |
Authorized Official Contact | 6313211286 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Healthstar Medical Pc 747 Montauk Highway West Islip NY 11795 Ph: (631) 321-1286 | Healthstar Medical Pc 747 Montauk Highway West Islip NY 11795 Ph: (631) 321-1286 |
NPI Number | 1548236094 |
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Provider Enumeration Date | 02/24/2006 |
Last Update Date | 05/13/2009 |
Medicare PECOS PAC ID | 9436048113 |
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Medicare Enrollment ID | O20110401000788 |
Identifier | Type | State | Issuer |
---|---|---|---|
1548236094 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Lada Osipova |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1982679023 PECOS PAC ID: 8729043641 Enrollment ID: I20041119000681 |
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