| Main Street Internal Medicine, Pllc | |
|
124 Main St Suite 12 Huntington NY 11743-6922 | |
| (631) 271-6406 | |
| Not Available |
| Full Name | Main Street Internal Medicine, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 124 Main St, Huntington, New York |
| Authorized Official Name and Position | Michel William Ghobrial (PRESIDENT) |
| Authorized Official Contact | 6312716406 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Internal Medicine, Pllc 124 Main St Suite 12 Huntington NY 11743-6922 Ph: (631) 271-6406 | Main Street Internal Medicine, Pllc 124 Main St Suite 12 Huntington NY 11743-6922 Ph: (631) 271-6406 |
| NPI Number | 1760433759 |
|---|---|
| Provider Enumeration Date | 05/13/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0143277293 |
|---|---|
| Medicare Enrollment ID | O20050331001239 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760433759 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 234668 (New York) | Primary |
| Provider Name | Michel William Ghobrial |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083663744 PECOS PAC ID: 2163323742 Enrollment ID: I20050404000817 |
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