Organization Name: | MLS MEDICAL SERVICES, P.C. |
NPI Number: | 1730360892 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT KORMENDI (PRESIDENT) |
Mailing Address: | 8339 Daniels St Briarwood |
State: | NY US |
Postal Code: | 114351208 |
Phone Number: | 7185234141 |
Fax Number: | 7182060302 |
NPI Enumeration Date: | 11/16/2007 |
NPI Last Update Date: | 11/16/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 206148 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |