| Medical Rover Ny Pllc | |
|
573 Larkfield Rd East Northport NY 11731-4203 | |
| (718) 362-8184 | |
| (718) 414-1651 |
| Full Name | Medical Rover Ny Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 573 Larkfield Rd, East Northport, New York |
| Authorized Official Name and Position | Krystal Mckenna (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 7183628184 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Rover Ny Pllc 228 E Route 59 # 400 Nanuet NY 10954-2905 Ph: (718) 362-8184 | Medical Rover Ny Pllc 573 Larkfield Rd East Northport NY 11731-4203 Ph: (718) 362-8184 |
| NPI Number | 1134873300 |
|---|---|
| Provider Enumeration Date | 02/07/2022 |
| Last Update Date | 02/07/2022 |
| Medicare PECOS PAC ID | 0547657306 |
|---|---|
| Medicare Enrollment ID | O20220425002205 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134873300 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Amir Herman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306867494 PECOS PAC ID: 0547278715 Enrollment ID: I20060329000579 |
| Provider Name | Veronica Ann Pope |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508502162 PECOS PAC ID: 7911380910 Enrollment ID: I20220823003044 |
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