| Medredefined Llc | |
|
345 Waterside Rd Northport NY 11768-1237 | |
| (631) 857-4439 | |
| Not Available |
| Full Name | Medredefined Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 345 Waterside Rd, Northport, New York |
| Authorized Official Name and Position | Manila Jindal (OWNER) |
| Authorized Official Contact | 8327680726 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medredefined Llc 240 Main St Unit 225 Northport NY 11768-5010 Ph: (832) 768-0726 | Medredefined Llc 345 Waterside Rd Northport NY 11768-1237 Ph: (631) 857-4439 |
| NPI Number | 1235982000 |
|---|---|
| Provider Enumeration Date | 04/10/2024 |
| Last Update Date | 05/03/2024 |
| Medicare PECOS PAC ID | 0345689436 |
|---|---|
| Medicare Enrollment ID | O20240423001296 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235982000 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | Manila Jindal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497286140 PECOS PAC ID: 2163708181 Enrollment ID: I20220824003294 |
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