| Mavroson Medical Pc | |
|
57 Laurel Ln Roslyn Heights NY 11577-1608 | |
| (516) 313-9949 | |
| Not Available |
| Full Name | Mavroson Medical Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 57 Laurel Ln, Roslyn Heights, New York |
| Authorized Official Name and Position | Matthew Nicholas Mavroson (PRESIDENT) |
| Authorized Official Contact | 5163139949 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mavroson Medical Pc 57 Laurel Ln Roslyn Heights NY 11577-1608 Ph: (516) 313-9949 | Mavroson Medical Pc 57 Laurel Ln Roslyn Heights NY 11577-1608 Ph: (516) 313-9949 |
| NPI Number | 1275230336 |
|---|---|
| Provider Enumeration Date | 02/09/2023 |
| Last Update Date | 06/23/2025 |
| Medicare PECOS PAC ID | 8628597366 |
|---|---|
| Medicare Enrollment ID | O20250527000282 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275230336 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Matthew Nicholas Mavroson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164712329 PECOS PAC ID: 7113286832 Enrollment ID: I20180125001160 |
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