Mitchel Field Family Health Center | |
West Road Building 19 Garden City NY 11530 | |
(516) 222-0228 | |
(516) 745-1519 |
Full Name | Mitchel Field Family Health Center |
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Speciality | Clinic/Center |
Location | West Road, Garden City, New York |
Authorized Official Name and Position | Steve Korf (PRESIDENT & CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 2123565962 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mitchel Field Family Health Center 5 Penn Plz Fl 9 New York NY 10001-1851 Ph: () - | Mitchel Field Family Health Center West Road Building 19 Garden City NY 11530 Ph: (516) 222-0228 |
NPI Number | 1790010817 |
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Provider Enumeration Date | 10/07/2009 |
Last Update Date | 07/19/2021 |
Medicare PECOS PAC ID | 5092622027 |
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Medicare Enrollment ID | O20210721001472 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790010817 | NPI | - | NPPES |
00243229 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 7002037H (New York) | Primary |
Provider Name | Roman Brushtein |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1194786772 PECOS PAC ID: 9032168570 Enrollment ID: I20050121000520 |
Provider Name | Betty A Kelly |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1861411969 PECOS PAC ID: 6103227814 Enrollment ID: I20210701000277 |
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