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Organization
FRESH MEADOWS MEDICAL SERVICES PLLC
Active
Organization
FRESH MEADOWS MEDICAL SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN ANTONELLI MD (OWNER)
(718) 217-1414
Entity
Organization
Contact information
Practice address
18904 UNION TPKE, FRESH MEADOWS, NY 11366-1862
(718) 217-1414
Mailing address
PO BOX 270, MASSAPEQUA PARK, NY 11762-0270
(631) 264-2035
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
NULL
207RG0100X
Gastroenterology Physician
Primary
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
NULL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
Other
Enumeration date
09/16/2016
Last updated
10/21/2016
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