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Organization
MEDMAN PRIMARY CARE MEDICINE PC
Active
Organization
MEDMAN PRIMARY CARE MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARRY H STARK (MD)
(516) 328-9797
Entity
Organization
Contact information
Practice address
2035 LAKEVILLE RD, NEW HYDE PARK, NY 11040-1661
(516) 328-9797
Mailing address
2035 LAKEVILLE RD, NEW HYDE PARK, NY 11040-1661
(516) 328-9797
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01722870
—
NY
01
—
05926I
MEDICARE ID
NY
Enumeration date
04/01/2009
Last updated
11/04/2010
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