1528225026 NPI number — REMED MEDICAL, P. C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528225026 NPI number — REMED MEDICAL, P. C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REMED MEDICAL, P. C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528225026
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9815 HORACE HARDING EXPY
Provider Second Line Business Mailing Address:
DOCTORS OFFICE
Provider Business Mailing Address City Name:
CORONA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11368-4249
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-699-8500
Provider Business Mailing Address Fax Number:
718-271-4897

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6254 97TH PL STE 2B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REGO PARK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11374-1354
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-595-1166
Provider Business Practice Location Address Fax Number:
718-595-1167
Provider Enumeration Date:
05/21/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MIKHAYLOV
Authorized Official First Name:
ARTUR
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICER
Authorized Official Telephone Number:
718-595-1166

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  226007 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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