Organization Name: | MID NASSAU MEDICAL CARE FOR KIDZ, LLC |
NPI Number: | 1710356043 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STEVEN PERRICK (M.D./PARTNER) |
Mailing Address: | 530 Old Country Rd Suite 1b Westbury |
State: | NY US |
Postal Code: | 115904500 |
Phone Number: | 5163337272 |
Fax Number: | 5163332519 |
NPI Enumeration Date: | 09/16/2015 |
NPI Last Update Date: | 09/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |