| Organization Name: | HEMPSTEAD MAIN MEDICAL, PC |
| NPI Number: | 1073648705 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THEOPHILUS OKEKE (MEDICAL DIRECTOR) |
| Mailing Address: | 2 Main St Hempstead |
| State: | NY US |
| Postal Code: | 115504020 |
| Phone Number: | 5164896600 |
| Fax Number: | 5164896640 |
| NPI Enumeration Date: | 02/22/2007 |
| NPI Last Update Date: | 04/09/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1300X |
| License Number: | 174557 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Multi-Specialty |
| Taxonomy Definition: | |