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Contact Information

MID-SUFFOLK MEDICAL CARE PC
6277 JERICHO TPKE
COMMACK, NY11725-2837
 Phone: 631-462-6644
 Fax: 631-462-9890
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Legal Medicine

173000000X
Indicates primary specialty

NPI Profile & details for MID SUFFOLK MEDICAL CARE PC · (Female)

NPI # 1811186083
Status Active
Credentials
Entity Individual
Enumeration date 10/23/2007
Last updated 01/08/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • NY License # 220310
  • NY Medicaid 02131226
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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