# ADVANCED INTERNAL MEDICINE, P.C.

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

## Provider details

- **NPI number:** 1467709451
- **Authorized official:** DR. SHAHRAM DANIEL SHAMEKH M.D. (PRESIDENT/CEO)
- **Authorized official phone:** (516) 455-7017

## Contact information

- **Practice address:** 935 NORTHERN BLVD STE 105, GREAT NECK, NY 11021-5309
- **Practice address phone:** (516) 487-0070
- **Practice address fax:** (516) 487-0072
- **Mailing address:** 130 GRISTMILL LN, GREAT NECK, NY 11023-1839
- **Mailing address phone:** (516) 455-7017

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 236142 | NY | Yes |

## Other

- **Enumeration date:** 08/08/2012
- **Last updated:** 11/28/2018