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Organization
QUALITY MEDICAL FITNESS, PC
Active
Organization
QUALITY MEDICAL FITNESS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIJAY B. GOPAL M.D. (PRESIDENT)
(631) 424-1170
Entity
Organization
Contact information
Practice address
389 FORT SALONGA RD STE 3, NORTHPORT, NY 11768-3044
(631) 424-1170
(631) 424-1171
Mailing address
389 FORT SALONGA RD STE 3, NORTHPORT, NY 11768-3044
(631) 424-1170
(631) 424-1171
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
238113
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
238113
NEW YORK STATE LICENSE
NY
Enumeration date
11/30/2015
Last updated
11/30/2015
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