| Roslyn Heights Medical Pc | |
|
114 Barnyard Ln Roslyn Heights NY 11577-2809 | |
| (516) 626-7583 | |
| (516) 626-0924 |
| Full Name | Roslyn Heights Medical Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 114 Barnyard Ln, Roslyn Heights, New York |
| Authorized Official Name and Position | Farzad Shokri Tabibzadeh (PRESIDENT) |
| Authorized Official Contact | 5166267583 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roslyn Heights Medical Pc 114 Barnyard Ln Roslyn Heights NY 11577-2809 Ph: (516) 626-7583 | Roslyn Heights Medical Pc 114 Barnyard Ln Roslyn Heights NY 11577-2809 Ph: (516) 626-7583 |
| NPI Number | 1629228523 |
|---|---|
| Provider Enumeration Date | 09/26/2008 |
| Last Update Date | 09/26/2008 |
| Medicare PECOS PAC ID | 1759459423 |
|---|---|
| Medicare Enrollment ID | O20081008000130 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629228523 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 194182 (New York) | Primary |
| Provider Name | Farzad Shokri-tabibzadeh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801819180 PECOS PAC ID: 6406924174 Enrollment ID: I20081008000117 |
| Provider Name | Limor Tabib |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1124775986 PECOS PAC ID: 7719362391 Enrollment ID: I20220919000117 |
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