| Omari Chubinidze Medical Pc | |
|
100 Newbridge Rd Ste 6 Hicksville NY 11801-3948 | |
| (516) 882-7473 | |
| Not Available |
| Full Name | Omari Chubinidze Medical Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 100 Newbridge Rd Ste 6, Hicksville, New York |
| Authorized Official Name and Position | Omari Chubinidze (OWNER) |
| Authorized Official Contact | 5028364318 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Omari Chubinidze Medical Pc 100 Newbridge Rd Ste 6 Hicksville NY 11801-3948 Ph: (516) 882-7473 | Omari Chubinidze Medical Pc 100 Newbridge Rd Ste 6 Hicksville NY 11801-3948 Ph: (516) 882-7473 |
| NPI Number | 1790390292 |
|---|---|
| Provider Enumeration Date | 09/11/2020 |
| Last Update Date | 09/11/2020 |
| Medicare PECOS PAC ID | 0345650578 |
|---|---|
| Medicare Enrollment ID | O20201029001296 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790390292 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Richard P Friedlander |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1528054137 PECOS PAC ID: 7618937673 Enrollment ID: I20041014000256 |
| Provider Name | Leon Kohanbash |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295914869 PECOS PAC ID: 8729132840 Enrollment ID: I20090824000438 |
| Provider Name | Natalia Beridze |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1700151032 PECOS PAC ID: 8022324870 Enrollment ID: I20150825003938 |
| Provider Name | Omar Ahmed |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1831517002 PECOS PAC ID: 9436466471 Enrollment ID: I20150923001953 |
| Provider Name | Surender Kurapati |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073558383 PECOS PAC ID: 8628982428 Enrollment ID: I20200310002128 |
| Provider Name | Omari Chubinidze |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669524096 PECOS PAC ID: 5698874535 Enrollment ID: I20201116001393 |
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