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Contact Information

369 MEDICAL PRACTICE PC
369 WHITE PLAINS RD FL 2
EASTCHESTER, NY10709-2805
 Phone: 914-395-3691
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Medicine & Rehabilitation

208100000X 25 Physician/Physical Medicine and Rehabilitation
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for 369 MEDICAL PRACTICE PC

NPI # 1376141325
LBN Legal business name 369 MEDICAL PRACTICE PC
Authorized official MACK SULLIVAN - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/13/2020
Last updated 10/17/2023 - About 3 years ago
Identifiers n/a
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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