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Contact Information

307 LONG ISLAND MEDICAL PC
307 E SHORE RD
2ND FLOOR
GREAT NECK, NY11023-2420
 Phone: 516-487-5858
 Fax: 516-487-3133
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for 307 LONG ISLAND MEDICAL PC

NPI # 1023206026
LBN Legal business name 307 LONG ISLAND MEDICAL PC
Authorized official SHANTA MALLIKARJUNA - (OFFICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/04/2007
Last updated 10/04/2007 - About 12 years ago
Identifiers
NY License # 227976-1
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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