| Heritage New York Medical Pc | |
|
501 Franklin Ave Ste. 140 Garden City NY 11530-5807 | |
| (516) 531-2001 | |
| Not Available |
| Full Name | Heritage New York Medical Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 501 Franklin Ave, Garden City, New York |
| Authorized Official Name and Position | Mary Kathleen Nix (CEO) |
| Authorized Official Contact | 5165312107 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heritage New York Medical Pc 501 Franklin Ave Ste. 140 Garden City NY 11530-5807 Ph: (516) 531-2001 | Heritage New York Medical Pc 501 Franklin Ave Ste. 140 Garden City NY 11530-5807 Ph: (516) 531-2001 |
| NPI Number | 1578982146 |
|---|---|
| Provider Enumeration Date | 04/10/2014 |
| Last Update Date | 11/15/2016 |
| Medicare PECOS PAC ID | 5991922643 |
|---|---|
| Medicare Enrollment ID | O20140804002243 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578982146 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 364S00000X | Clinical Nurse Specialist | 11-3284153 (New York) | Secondary |
| Provider Name | Michelle Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316353162 PECOS PAC ID: 8921318098 Enrollment ID: I20151103000631 |
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