Basic Information
| Provider Information | |||||||||
| NPI: | 1174588214 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | LONG TERM MEDICAL CARE ASSOCIATES, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 222 STATION PLZ N | ||||||||
| Address2: | STE 518 | ||||||||
| City: | MINEOLA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115013808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166634630 | ||||||||
| FaxNumber: | 5166634644 | ||||||||
| Practice Location | |||||||||
| Address1: | 378 SYOSSET WOODBURY RD | ||||||||
| Address2: | |||||||||
| City: | WOODBURY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117971200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5169213900 | ||||||||
| FaxNumber: | 5166634644 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2006 | ||||||||
| LastUpdateDate: | 08/02/2010 | ||||||||
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| AuthorizedOfficialLastName: | FISCHER | ||||||||
| AuthorizedOfficialFirstName: | KAREN | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5166634630 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 173000000X | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Legal Medicine |
No ID Information.