# LONG ISLAND PRIMARY MEDICAL CARE/DBA VILLAGE PEDIATRICS

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

## Provider details

- **NPI number:** 1316992886
- **Authorized official:** JEFFREY W. LIEBERMAN MD (PHYSICIAN)
- **Authorized official phone:** (516) 248-8334

## Contact information

- **Practice address:** 975 FRANKLIN AVE, SUITE 101, GARDEN CITY, NY 11530-2911
- **Practice address phone:** (516) 248-8334
- **Mailing address:** 975 FRANKLIN AVENUE,SUITE 101, SUITE 101, GARDEN CITY, NY 11783

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | NY | Yes |

## Other

- **Enumeration date:** 05/23/2006
- **Last updated:** 08/22/2020