| Hicksville Primary Medical Care Pllc | |
|
380 S Broadway Hicksville NY 11801-5033 | |
| (516) 937-7600 | |
| (718) 343-7603 |
| Full Name | Hicksville Primary Medical Care Pllc |
|---|---|
| Speciality | Internal Medicine - Geriatric Medicine |
| Location | 380 S Broadway, Hicksville, New York |
| Authorized Official Name and Position | Ankur Patel (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 9089667395 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hicksville Primary Medical Care Pllc 380 S Broadway Hicksville NY 11801-5033 Ph: (516) 937-7600 | Hicksville Primary Medical Care Pllc 380 S Broadway Hicksville NY 11801-5033 Ph: (516) 937-7600 |
| NPI Number | 1598222960 |
|---|---|
| Provider Enumeration Date | 02/21/2019 |
| Last Update Date | 02/21/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598222960 | NPI | - | NPPES |
| 225462 | Other | NY | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
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