| Leisure Village Medical Services Pllc | |
|
681 Whiskey Rd Unit 2 Ridge NY 11961-8351 | |
| (631) 675-0488 | |
| (934) 899-0421 |
| Full Name | Leisure Village Medical Services Pllc |
|---|---|
| Speciality | Internal Medicine - Geriatric Medicine |
| Location | 681 Whiskey Rd Unit 2, Ridge, New York |
| Authorized Official Name and Position | Nathanael Desire (OWNER) |
| Authorized Official Contact | 6318067341 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leisure Village Medical Services Pllc 681 Whiskey Rd Unit 2 Ridge NY 11961-8351 Ph: (631) 675-0488 | Leisure Village Medical Services Pllc 681 Whiskey Rd Unit 2 Ridge NY 11961-8351 Ph: (631) 675-0488 |
| NPI Number | 1922931344 |
|---|---|
| Provider Enumeration Date | 06/05/2026 |
| Last Update Date | 06/05/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922931344 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
Gpc Consultants Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 681 Whiskey Rd Unit 2, Ridge, NY 11961 Phone: 631-675-0488 Fax: 631-910-2022 | |
Custom Fit Wellness Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1808 Middle Country Rd, Ridge, NY 11961 Phone: 516-946-9417 |