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Organization
GREAT NECK MEDICAL ASSOCIATES, LLP
Active
Organization
GREAT NECK MEDICAL ASSOCIATES, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT KELLMAN MD (ADMINISTRATOR)
(516) 608-6820
Entity
Organization
Contact information
Practice address
2800 MARCUS AVE, SUITE 200, LAKE SUCCESS, NY 11042
(516) 608-6820
(516) 608-6822
Mailing address
2 OHIO DR, LAKE SUCCESS, NY 11042-1111
(516) 608-6820
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0100X
Gastroenterology Physician
—
NULL
207RG0100X
Gastroenterology Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
NULL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
NULL
207RP1001X
Pulmonary Disease Physician
—
—
Other
Enumeration date
05/09/2006
Last updated
03/07/2011
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