# EAST MEADOW FAMILY PRACTICE ASSOC PC

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

## Provider details

- **NPI number:** 1326117110
- **Authorized official:** BRIAN T MOYNIHAN DO (PRESIDENT)
- **Authorized official phone:** (516) 781-1141

## Contact information

- **Practice address:** 2840 JERUSALEM AVE, WANTAGH, NY 11793-2017
- **Practice address phone:** (516) 781-1141
- **Practice address fax:** (516) 781-1184
- **Mailing address:** 2840 JERUSALEM AVE, WANTAGH, NY 11793-2017
- **Mailing address phone:** (516) 781-1141
- **Mailing address fax:** (516) 781-1184

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/07/2006
- **Last updated:** 04/18/2008