# DR. MOHAMED IDRIS MEDICAL PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053628933
- **Authorized official:** DR. MOHAMED HUSSEIN IDRIS M.D. (OWNER)
- **Authorized official phone:** (516) 582-8356

## Contact information

- **Practice address:** 55 N MAIN ST, FREEPORT, NY 11520-2243
- **Practice address phone:** (516) 538-0295
- **Practice address fax:** (516) 538-0296
- **Mailing address:** 27 BALFOUR DR, BETHPAGE, NY 11714-5527
- **Mailing address phone:** (516) 538-0295
- **Mailing address fax:** (516) 538-0296

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 228816 | NY | Yes |

## Other

- **Enumeration date:** 09/13/2010
- **Last updated:** 09/13/2010