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OCEANSIDE, NY 115723255
Organization
54 MAIN STREET MEDICAL PRACTICE PC
NPI 1386711497
Active
Family Medicine
Quick Facts
NPI Number
1386711497
Type
Organization (NPI-2)
Status
Active
Enumeration Date
2006-11-30
Last Updated (NPPES)
2021-10-21
Primary Specialty / Taxonomy
| Taxonomy | Family Medicine |
| Taxonomy Code | 207Q00000X |
Mailing Address
2965 LONG BEACH RDOCEANSIDE, NY 115723255
Data sourced live from the CMS NPPES NPI Registry (npiregistry.cms.hhs.gov) and cached locally. This is a public directory lookup, not a credentialing or verification service — confirm critical details directly with NPPES or the provider.