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Organization
NORTH VALLEY MEDICAL, PC
Active
Organization
NORTH VALLEY MEDICAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DAWN COBURN PA (OFFICE MANAGER)
(516) 351-4046
Entity
Organization
Contact information
Practice address
234-32 MERRICK BLVD, ROSEDALE, NY 11422
(718) 276-4482
(718) 276-5083
Mailing address
25931 148TH DR, ROSEDALE, NY 11422-3001
(516) 351-4046
(718) 276-5083
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
198832
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01617674
—
NM
Enumeration date
07/05/2007
Last updated
06/17/2009
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