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Organization

HERITAGE NEW YORK MEDICAL PC

Active
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Organization

HERITAGE NEW YORK MEDICAL PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARY KATHLEEN NIX RN (CEO)
(516) 531-2107
Entity
Organization

Contact information

Practice address
501 FRANKLIN AVE, STE. 140, GARDEN CITY, NY 11530-5807
(516) 531-2001
Mailing address
501 FRANKLIN AVE, STE. 140, GARDEN CITY, NY 11530-5807
(516) 531-2001

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
364S00000X
Clinical Nurse Specialist
11-3284153
NY

Other

Enumeration date
04/10/2014
Last updated
11/15/2016
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