Basic Information
| Provider Information | |||||||||
| NPI: | 1164751194 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MOBILE HEALTH MEDICAL SERVICES PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 61 MANORHAVEN BLVD | ||||||||
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| City: | PORT WASHINGTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110501627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5168837100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 229 W 36TH ST | ||||||||
| Address2: | 10TH FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100187529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2126955122 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/22/2009 | ||||||||
| LastUpdateDate: | 05/06/2010 | ||||||||
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| AuthorizedOfficialLastName: | PATEL | ||||||||
| AuthorizedOfficialFirstName: | NALINIKANT | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2126955122 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.