| Infectious Disease Practice Of Long Island Pc | |
|
165 N Village Ave Suite 107 Rockville Centre NY 11570-3761 | |
| (516) 442-4991 | |
| Not Available |
| Full Name | Infectious Disease Practice Of Long Island Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 165 N Village Ave, Rockville Centre, New York |
| Authorized Official Name and Position | Maqsood Alam (PRESIDENT) |
| Authorized Official Contact | 5164333750 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Infectious Disease Practice Of Long Island Pc 215 Willets Ln Jericho NY 11753-1613 Ph: (516) 433-3750 | Infectious Disease Practice Of Long Island Pc 165 N Village Ave Suite 107 Rockville Centre NY 11570-3761 Ph: (516) 442-4991 |
| NPI Number | 1114267234 |
|---|---|
| Provider Enumeration Date | 02/26/2013 |
| Last Update Date | 02/26/2013 |
| Medicare PECOS PAC ID | 8628218294 |
|---|---|
| Medicare Enrollment ID | O20130702000064 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114267234 | NPI | - | NPPES |
| 2780514 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 233680 (New York) | Primary |
| Provider Name | Maqsood Alam |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1326044926 PECOS PAC ID: 1759387897 Enrollment ID: I20061012000568 |
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