# LONG ISLAND MEDICAL ARTS PLLC

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

## Provider details

- **NPI number:** 1124499157
- **Authorized official:** DR. TAREK M MOUSA MD, PHD (PRESIDENT)
- **Authorized official phone:** (347) 556-7769

## Contact information

- **Practice address:** 393 SUNRISE HWY, SUITE\#7, WEST BABYLON, NY 11704-5909
- **Practice address phone:** (347) 556-7769
- **Mailing address:** 393 SUNRISE HWY, SUITE\#7, WEST BABYLON, NY 11704-5909

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 259363 | NY | Yes |

## Other

- **Enumeration date:** 10/16/2015
- **Last updated:** 10/16/2015