| Long Island Professional Medical Services Pc | |
|
901 Stewart Ave Ste 275 Garden City NY 11530 | |
| (516) 877-1518 | |
| (516) 877-1561 |
| Full Name | Long Island Professional Medical Services Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 901 Stewart Ave, Garden City, New York |
| Authorized Official Name and Position | Philip Fortunato Spadafora (PHYSICIAN PRESIDENT) |
| Authorized Official Contact | 5168771518 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Long Island Professional Medical Services Pc 901 Stewart Ave Ste 275 Garden City NY 11530 Ph: (516) 877-1518 | Long Island Professional Medical Services Pc 901 Stewart Ave Ste 275 Garden City NY 11530 Ph: (516) 877-1518 |
| NPI Number | 1295788966 |
|---|---|
| Provider Enumeration Date | 05/17/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1759272578 |
|---|---|
| Medicare Enrollment ID | O20040322001610 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295788966 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 1878871 (New York) | Primary |
| Provider Name | Philip Fortunato Spadafora |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255386959 PECOS PAC ID: 7214979038 Enrollment ID: I20050523000704 |
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