# MASSAPEQUA MEDICAL PC

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

## Provider details

- **NPI number:** 1609144096
- **Authorized official:** DR. MARWAN HAMMOUD M.D. (PRESIDENT)
- **Authorized official phone:** (516) 798-8090

## Contact information

- **Practice address:** 727 N BROADWAY, SUITE A1, MASSAPEQUA, NY 11758-2348
- **Practice address phone:** (516) 798-8090
- **Practice address fax:** (516) 795-3606
- **Mailing address:** 727 N BROADWAY, SUITE A1, MASSAPEQUA, NY 11758-2348
- **Mailing address phone:** (516) 798-8090
- **Mailing address fax:** (516) 795-3606

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | 233296 | NY | Yes |

## Other

- **Enumeration date:** 12/13/2011
- **Last updated:** 12/13/2011